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Care Coordination Measures Atlas Update

Chapter 6. Measure Maps and Profiles (continued, 14)

Measures 35-38a

Measure #35. Picker Patient Experience (PPE-15)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate      
   Interpersonal communication ■    
   Information transfer □    
Facilitate transitions      
   Across settings      
   As coordination needs change      
Assess needs and goals □    
Create a proactive plan of care      
Monitor, follow up, and respond to change      
Support self-management goals ■    
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination □    
Health care home      
Care management      
Medication management □    
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Picker Patient Experience (PPE-15)

Purpose: To develop and test an instrument to measure inpatient care experiences from the patient perspective.

Format/Data Source: A 15-item survey implemented in 5 countries. Items are grouped into 8 dimensions on the basis of face validity: (1) information and education, (2) coordination of care, (3) physical comfort, (4) emotional support, (5) respect for patient preferences, (6) involvement of family and friends, (7) continuity and transition, and (8) overall impression.

Date: Measure published in 2002.1

Perspective: Patient/Family

Measure Item Mapping:

  • Communicate:
    • Interpersonal communication:
      • Between health care professional(s) and patient/family: 1-4, 8, 11
    • Information transfer:
      • Between health care professional(s) and patient/family: 12, 13
  • Assess needs and goals: 4, 8
  • Support self-management goals: 6, 9, 14, 15
  • Teamwork focused on coordination: 3
  • Medication management: 13, 14

Development and Testing: Items were developed from the Picker adult inpatient questionnaire, and were required to address 4 criteria: (1) patient applicability, (2) high correlation of items, (3) high internal consistency reliability levels, and (4) total item correlations exceeding the recommended 0.3 value. Development included expert consultation, a systematic literature review, organization of patient focus groups, and in-depth interviews to confirm salience in health care encounters. Evidence indicates that the Picker Patient Experience Questionnaire (PPE-15) has high levels of internal consistency reliability. Cronbach's alpha coefficient exceeded the recommended value of 0.7, and Spearman correlations (item-total correlations) were acceptable, except for 1 item, which fell below accepted values in Sweden and the United States.1

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: None described in the sources identified.

Country: Germany, Sweden, Switzerland, United Kingdom and United States

Past or Validated Applications*:

  • Patient Age: Adults
  • Patient Condition: General Population/Not Condition Specific
  • Setting: Inpatient Facility

*Based on the sources listed below.

Notes:

  • All instrument items are located in the Appendix of the source article.1
  • This instrument contains 15 items; 12 were mapped.

Sources:

1. Jenkinson C, Coulter A, Bruster S. The Picker Patient Experience Questionnaire: Development and validation using data from in-patient surveys in five countries. Int J Qual Health Care 2002;14(5):353-58.
2. Cleary PD, Edgman-Levitan S, Walker JD, et al. Using patient reports to improve medical care: A preliminary report from 10 hospitals. Qual Manage Health Care 1993;2(1):31-8.

Measure #36. Physician Office Quality of Care Monitor (QCM)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate      
   Interpersonal communication □    
   Information transfer ■    
Facilitate transitions      
   Across settings      
   As coordination needs change      
Assess needs and goals      
Create a proactive plan of care      
Monitor, follow up, and respond to change □    
Support self-management goals □    
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination □    
Health care home      
Care management      
Medication management □    
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Physician Office Quality of Care Monitor (QCM)

Purpose: To accurately measure patient perceptions of care quality in the physician's office.

Format/Data Source: 56-item, mailed survey addressing 4 main dimensions of patient satisfaction: (1) evaluation of medical care in geographical areas, (2) beliefs about physician behavior, (3) reasons for postponing physician visits, and (4) attitudes toward the physician and medical care. The QCM identified 7 distinct scales of physician office care, which include: (1) Physician Care, (2) Nursing Care, (3) Front Office Services, (4) Accessibility, (5) Billing, (6) Testing Services, and (7) Facility Characteristics.

Date: Measure published in 1996.1

Perspective: Patient/Family

Measure Item Mapping:

  • Communicate:
    • Interpersonal communication:
      • Between health care professional(s) and patient/family: 36
    • Information transfer:
      • Between health care professional(s) and patient/family: 18, 21, 35
  • Monitor, follow up, and respond to change: 30, 32
  • Support self-management goals: 31
  • Teamwork focused on coordination: 33
  • Medication management: 30, 43

Development and Testing: After reviewing the literature and published questionnaires, items included in the Physician Office Quality of Care Monitor (QCM) were refined based on patient interviews as well as pilot testing via post-visit mailed surveys. The QCM demonstrated strong construct validity through a Promax oblique rotation, and factor analysis yielded sufficient predictive validity. Internal consistency of the scales supported reliability through Cronbach's alpha coefficients, which exceeded respective correlations and met the guidelines.1

Link to Outcomes or Health System Characteristics: None described in the source identified.

Logic Model/Conceptual Framework: None described in the source identified.

Country: United States

Past or Validated Applications*:

  • Patient Age: Not Age Specific
  • Patient Condition: General Population/Not Condition Specific
  • Setting: Primary Care Facility, Other Outpatient Specialty Care Facility

*Based on the source listed below

Notes:

  • For simplification purposes, in order to properly reference specific items within this profile, all instrument items found in the Appendix of the source article were consecutively numbered.1
  • This instrument contains 53 forced-choice items; 9 were mapped.

Sources:

1. Seibert JH, Strohmeyer JM, Carey RG. Evaluating the physician office visit: In pursuit of a valid and reliable measure of quality improvement efforts. J Ambul Care Manage 1996;19(1):17-37.

Measure #37. Patient Perceptions of Care (PPOC)

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility ■    
Communicate ■    
   Interpersonal communication ■    
   Information transfer ■    
Facilitate transitions      
   Across settings □    
   As coordination needs change      
Assess needs and goals ■    
Create a proactive plan of care □    
Monitor, follow up, and respond to change ■    
Support self-management goals □    
Link to community resources      
Align resources with patient and population needs      
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination      
Health care home      
Care management      
Medication management □    
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Patient Perceptions of Care (PPOC)

Purpose: To measure and determine Veterans Administration (VA) patients' perceptions of care in community-based outpatient clinics (CBOCs).

Format/Data Source: Mailed, self-administered, 40-item, cross-sectional survey addressing 8 multi-item scales: (1) access and timeliness of care, (2) patient education/information, (3) patient preferences, (4) emotional support, (5) coordination of care (overall), (6) coordination of are (visit), (7) courtesy, and (8) specialty provider access. The Picker-Commonwealth approach was used to measure of patient perceptions of care.

Date: Measure published in 2002.1

Perspective: Patient/Family

Measure Item Mapping:

  • Establish accountability or negotiate responsibility: 13, 14, 28-31, 34
  • Communicate:
    • Between health care professional(s) and patient/family: 8, 9, 15, 16, 20, 30, 31
  • Interpersonal communication:
    • Between health care professional(s) and patient/family: 18, 19, 27
  • Information transfer:
    • Between health care professional(s) and patient/family: 10-12, 14, 30, 31, 39, 40
    • Across health care teams or settings: 26
    • Participants not specified: 24, 25
  • Facilitate transitions:
    • Across settings: 33
  • Assess needs and goals: 14, 15, 17
  • Create a proactive plan of care: 28
  • Monitor, follow up, and respond to change: 26, 32, 33
  • Support self-management goals: 17, 28
  • Medication management: 11, 12

Development and Testing: This measure is based on components of the 1998 VA National Outpatient Customer Satisfaction Survey, conducted by the VA National Performance Data Resource Center.1 Similar items have been used in the Veterans Satisfaction Survey.2

Link to Outcomes or Health System Characteristics: Delivery of care through VA Community-based Outpatient Clinics (CBOCs) was associated with small, but significant improvements in the number of reported problems with care, as measured through the PPOC, over delivery at VA medical centers, even when controlling for patient health status.1 Two domains of patient-centered care measured in the PPOC—communication between patients and providers and continuity of care—were also associated with better compliance rates for 12 recommended preventive care services at VA facilities.2

Logic Model/Conceptual Framework: The measures of patient perceptions of care included in the PPOC are based on the Picker-Commonwealth approach.1

Country: United States

Past or Validated Applications*:

  • Patient Age: Not Age Specific
  • Patient Condition: General Population/Not Condition Specific
  • Setting: Primary Care Facility, Other Outpatient Specialty Care Facility

*Based on the source listed below

Notes:

  • For simplification purposes, in order to properly reference specific items within this profile, all instrument items found in Appendix A of the source article were consecutively numbered.1
  • This instrument contains 40 items; 26 were mapped.
  • Both the 1998 VA National Outpatient Customer Satisfaction Survey, conducted by the VA National Performance Data Resource Center, and the 1999 Veterans Satisfaction Survey (VSS) contained nearly identical items addressing patient-centered care. Only the portions of the VA surveys that address patient-centered care, and which were reported in the sources listed in this profile, are described here as the Patient Perceptions of Care Survey.1, 2

Sources:

1. Borowsky SJ, Nelson DB, Fortney JC, et al. VA Community-Based Outpatient Clinics: Performance measures based on patient perceptions of care. Med Care 2002;40(7):578-86.
2. Flach SD, McCoy KD, Vaughn TE, et al. Does patient-centered care improve provision of preventive services? J Gen Int Med 2004;19:1019-26.

Measure #38a. PREPARED Survey – Patient Version

Care Coordination Measure Mapping Table

  Measurement Perspective:
Patient/Family Health Care
Professional(s)		 System
Representative(s)
Care Coordination Activities
Establish accountability or negotiate responsibility      
Communicate □    
   Interpersonal communication      
   Information transfer ■    
Facilitate transitions      
   Across settings ■    
   As coordination needs change      
Assess needs and goals □    
Create a proactive plan of care □    
Monitor, follow up, and respond to change      
Support self-management goals ■    
Link to community resources ■    
Align resources with patient and population needs ■    
Broad Approaches Potentially Related to Care Coordination
Teamwork focused on coordination      
Health care home      
Care management      
Medication management ■    
Health IT-enabled coordination      

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

PREPARED Survey — Patient Version

Purpose: To gather information on the quality of process and outcomes of discharge planning activities undertaken in the acute hospital setting from the patient perspective.

Format/Data Source: 49-item questionnaire covering 4 key domains: (1) information exchange (community services and equipment), (2) medication management, (3) preparation for coping after discharge, and (4) control of discharge circumstances.

Date: Measure released in 1998.1

Perspective: Patient/Family

Measure Item Mapping:

  • Communicate:
    • Between health care professional(s) and patient/family: 2.4
  • Information transfer:
    • Between health care professional(s) and patient/family: 2.1, 2.2, 2.5-2.7, 3.3
  • Facilitate transitions:
    • Across settings: 3.1-3.3
  • Assess needs and goals: 5.5
  • Create a proactive plan of care: 2.3
  • Support self-management goals: 2.7, 3.2, 3.3, 5.2, 6.2
  • Link to community resources: 2.6, 3.1, 5.5
  • Align resources with patient and population needs: 2.6, 3.1, 5.5
  • Medication management: 2.1-2.3, 2.5

Development and Testing: Initial instrument developed based on extensive interviews with hospital staff, patients, and patient carers. The draft instrument was then reviewed by an expert panel of health professionals, a questionnaire layout designer, discharge planning staff, a health economist, and a qualitative researcher to further test for face and content validity. The instrument was then pilot tested, and factor analysis was conducted on patient and carer responses to the process questions. The validity of the instrument was established by comparing responses with interview data and by correlating the process and outcome domains. Divergent validity of the instrument was established by comparing responses to MOS SF-36, a measure of physical and mental health scores.2

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: None described in the sources identified.

Country: Australia

Past or Validated Applications*:

  • Patient Age: Adults, Older Adults
  • Patient Condition: General Population/Not Condition Specific
  • Setting: Inpatient Facility, Primary Care Facility

*Based on the sources listed below and input from measure developer.

Notes:

  • The PREPARED instrument is available in 6 versions: (1) Australian Patient Version, (2) Australian Carer Version, (3) Australian Residential Care Staff Version, (4) Australian Community Service Provider Version, (5) Australian Medical Practitioner Version, and (6) American Medical Practitioner Version. All of the Australian instruments can be found online.1
  • This instrument contains 49 items; 13 were mapped.

Sources:

1. International Centre for Allied Health Evidence (iCAHE) Web site. Available at: http://www.unisa.edu.au/cahe/Resources/DCP/Information.asp. Accessed: 21 September 2010.
2. Grimmer K, Moss J. The development, validity and application of a new instrument to assess the quality of discharge planning activities from the community perspective. Int J Qual Health Care 2001;13(2):109-16.
3. Grimmer KA, Moss JR, Gill TK. Discharge planning quality from the carer perspective. Qual Life Res 2000;9:1005-13.

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Publication:
14-0037-EF

Previous Publication: 11-0023-EF

Page last reviewed June 2014
Page originally created June 2014

Internet Citation: Chapter 6. Measure Maps and Profiles (continued, 14). Content last reviewed June 2014. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/ncepcr/care/coordination/atlas/chapter6m.html

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