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Development and testing of a measure designed to assess the quality of care transitions

BACKGROUND: To improve the quality of care delivered to older persons receiving care across multiple settings, interventions are needed. However, the absence of a patient-centred measure specifically designed to assess this care has constrained innovation. OBJECTIVE: To develop a rigorously designed...

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Autores principales: Coleman, Eric A., Smith, Jodi D., Frank, Janet C., Eilertsen, Theresa B., Thiare, Jill N., Kramer, Andrew M.
Formato: Texto
Lenguaje:English
Publicado: Igitur, Utrecht Publishing & Archiving 2002
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480381/
https://www.ncbi.nlm.nih.gov/pubmed/16896392
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author Coleman, Eric A.
Smith, Jodi D.
Frank, Janet C.
Eilertsen, Theresa B.
Thiare, Jill N.
Kramer, Andrew M.
author_facet Coleman, Eric A.
Smith, Jodi D.
Frank, Janet C.
Eilertsen, Theresa B.
Thiare, Jill N.
Kramer, Andrew M.
author_sort Coleman, Eric A.
collection PubMed
description BACKGROUND: To improve the quality of care delivered to older persons receiving care across multiple settings, interventions are needed. However, the absence of a patient-centred measure specifically designed to assess this care has constrained innovation. OBJECTIVE: To develop a rigorously designed and tested measure, the Care Transition Measure (CTM). SETTING: A large, integrated managed care organisation in Colorado with approximately 55,000 members over the age of 65 years. PARTICIPANTS: Patients 65 years and older who were recently discharged from hospital and received subsequent skilled nursing care in a facility or in the home. METHODS: Six focus groups of older persons and their caregivers (n=49) were established. Standard qualitative analytic techniques were applied to written transcripts and four key domains were identified: (1) information transfer; (2) patient and caregiver preparation; (3) self-management support; and (4) empowerment to assert preferences. Specific CTM items were developed, pilot tested, and refined. Psychometric testing, conducted in a different population but selected using the same entry criteria (n=60), included content and construct validity, intra-item variation, and floor/ceiling properties. RESULTS: Older patients and clinicians found the measure to be highly relevant and comprehensive (i.e. content validity). Construct validity was assessed by comparing items from the CTM to selected items from a measure developed by Hendriks and colleagues (Medical Care 2001; 39(3): 270–283). Inter-item Spearman correlations ranged 0.388–0.594. No significant floor or ceiling effects were detected. CONCLUSIONS: The CTM was developed with substantial input from older patients and their caregivers. Psychometric testing suggested that the measure was valid. The CTM may serve to fill an important gap in health system performance evaluation by measuring the quality of care delivered across settings.
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spelling pubmed-14803812006-08-07 Development and testing of a measure designed to assess the quality of care transitions Coleman, Eric A. Smith, Jodi D. Frank, Janet C. Eilertsen, Theresa B. Thiare, Jill N. Kramer, Andrew M. Int J Integr Care Research and Theory BACKGROUND: To improve the quality of care delivered to older persons receiving care across multiple settings, interventions are needed. However, the absence of a patient-centred measure specifically designed to assess this care has constrained innovation. OBJECTIVE: To develop a rigorously designed and tested measure, the Care Transition Measure (CTM). SETTING: A large, integrated managed care organisation in Colorado with approximately 55,000 members over the age of 65 years. PARTICIPANTS: Patients 65 years and older who were recently discharged from hospital and received subsequent skilled nursing care in a facility or in the home. METHODS: Six focus groups of older persons and their caregivers (n=49) were established. Standard qualitative analytic techniques were applied to written transcripts and four key domains were identified: (1) information transfer; (2) patient and caregiver preparation; (3) self-management support; and (4) empowerment to assert preferences. Specific CTM items were developed, pilot tested, and refined. Psychometric testing, conducted in a different population but selected using the same entry criteria (n=60), included content and construct validity, intra-item variation, and floor/ceiling properties. RESULTS: Older patients and clinicians found the measure to be highly relevant and comprehensive (i.e. content validity). Construct validity was assessed by comparing items from the CTM to selected items from a measure developed by Hendriks and colleagues (Medical Care 2001; 39(3): 270–283). Inter-item Spearman correlations ranged 0.388–0.594. No significant floor or ceiling effects were detected. CONCLUSIONS: The CTM was developed with substantial input from older patients and their caregivers. Psychometric testing suggested that the measure was valid. The CTM may serve to fill an important gap in health system performance evaluation by measuring the quality of care delivered across settings. Igitur, Utrecht Publishing & Archiving 2002-06-01 /pmc/articles/PMC1480381/ /pubmed/16896392 Text en Copyright 2002, International Journal of Integrated Care (IJIC)
spellingShingle Research and Theory
Coleman, Eric A.
Smith, Jodi D.
Frank, Janet C.
Eilertsen, Theresa B.
Thiare, Jill N.
Kramer, Andrew M.
Development and testing of a measure designed to assess the quality of care transitions
title Development and testing of a measure designed to assess the quality of care transitions
title_full Development and testing of a measure designed to assess the quality of care transitions
title_fullStr Development and testing of a measure designed to assess the quality of care transitions
title_full_unstemmed Development and testing of a measure designed to assess the quality of care transitions
title_short Development and testing of a measure designed to assess the quality of care transitions
title_sort development and testing of a measure designed to assess the quality of care transitions
topic Research and Theory
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480381/
https://www.ncbi.nlm.nih.gov/pubmed/16896392
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