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- Title
Developing a patient reported measure of care co-ordination.
- Authors
Goodwin, Nick; Crump, Helen; King, Jenny; Thorlby, Ruth; Graham, Chris
- Abstract
Introduction: Older people with chronic conditions often receive poor care because of the fragmented way their services are co-ordinated. Addressing such problems is often overlooked by care providers as the views of older patients and carers about their experiences of care coordination are rarely captured. The project aim is to produce a robust user-reported measure that can capture the experience of older people with chronic conditions receiving health and/or social care services from different providers. This tool, under development by the International Foundation for Integrated Care, National Voices, the Nuffield Trust, the Picker Institute, and The King's Fund in England, and funded by the Aetna Foundation, will assess coherence, coordination and quality of care. It will be designed primarily for quality improvement. Theory/methods: A literature review was conducted to identify relevant existing materials, which were considered alongside work by National Voices and the Picker Institute. A draft questionnaire was produced and tested using focus groups drawn from the target audience, validation by healthcare professionals, and piloting. Piloting is almost complete and the content validity of the questionnaire is now being investigated. As part of the project, we are also producing a user guide that will provide context and learning from the pilot. Results: The questionnaire performed well during cognitive testing. Preliminary findings from the pilot show: An overall response rate of 27.5% - lower than hoped for, however delays at some pilot sites in the distribution of questionnaire packs may have affected this. 499 out of 527 respondents (95%) answered 30 or more of the 46 questions in the survey. Only three respondents answered fewer than 10 questions. 26 items achieved one or more positive correlations over 0.5 with other items in the survey. Three instances of positive associations over 0.7 were found. One question had 17 positive associations stronger that 0.5 with other questions in the survey. The average item non response for the survey was 3.9%. Two questions in the survey had 0% item non-response. The largest item non-response was 8.9%. Only 3% of total comments given to the questionnaire related to issues with the survey. Discussion: Provisional findings suggest that overall the questionnaire performs well. However, there may be a need to remove a small number of poor performing items, and to edit the survey tool based on suggestions from the project's expert advisory group. Clinicians and managers at pilot sites say the tool focuses on issues that are important to them, and that its objectives are well aligned with their own care co-ordination and service redesign goals. However, pilot site recruitment was slow, possibly due to the volume of pilots already underway in the English NHS. Conclusion: The questionnaire aims to occupy an area where no similar tools exist at present. Further piloting will be required to test whether the tool can assist commissioners and providers in improving the quality of their care co-ordination work.
- Subjects
HEALTH of older people; HEALTH &; social status
- Publication
International Journal of Integrated Care (IJIC), 2015, Vol 15, p49
- ISSN
1568-4156
- Publication type
Article