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Development and application of a survey instrument to measure collaboration among health care and social services organizations.

ABSTRACT: OBJECTIVE:To measure strategies of interorganizational collaboration among health care and social service organizations that serve older adults. STUDY SETTING:Twenty Hospital Service Areas (HSAs) in the United States. STUDY DESIGN:We developed and validated a novel scale to characterize interorganizational collaboration, and then tested its application by assessing whether the scale differentiated between HSAs with high vs low performance on potentially avoidable health care use and spending for Medicare beneficiaries. DATA COLLECTION:Health care and social service organizations (N = 173 total) in each HSA completed a 12-item collaboration scale, three questions about collaboration behaviors, and a detailed survey documenting collaborative network ties. PRINCIPAL FINDINGS:We identified two distinguishable subscales of interorganizational collaboration: (a) Aligning Strategy and (b) Coordinating Current Work. Each subscale demonstrated convergent validity with the organization's position in the collaborative network, and with collaboration behaviors. The full scale and Coordinating Current Work subscale did not differentiate high- vs low-performing HSAs, but the Aligning Strategy subscale was significantly higher in high-performing HSAs than in low-performing HSAs (P = .01). CONCLUSIONS:Cross-sector collaboration-and particularly Aligning Strategy-is associated with health care use and spending for older adults. This new survey measure could be used to track the impact of interventions to foster interorganizational collaboration.

SUBMITTER: Brewster AL

PROVIDER: S-EPMC6863239 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Development and application of a survey instrument to measure collaboration among health care and social services organizations.

Brewster Amanda L AL Tan Annabel X AX Yuan Christina T CT

Health services research 20191008 6

<h4>Objective</h4>To measure strategies of interorganizational collaboration among health care and social service organizations that serve older adults.<h4>Study setting</h4>Twenty Hospital Service Areas (HSAs) in the United States.<h4>Study design</h4>We developed and validated a novel scale to characterize interorganizational collaboration, and then tested its application by assessing whether the scale differentiated between HSAs with high vs low performance on potentially avoidable health car ...[more]

PMID: 31595498

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Project description:BackgroundPatient care ownership is essential to delivering high-quality medical care but appears to be eroding among trainees. The lack of an objective measure has limited the study of ownership in physicians.ObjectiveTo develop an instrument to measure psychological ownership of patient care.DesignCross-sectional study.ParticipantsInternal medicine trainees in a large, academic hospital completing an inpatient rotation.Main measuresOur scale prototype adapted an existing ownership scale (developed in the non-medical setting) based on themes identified in qualitative studies of patient care ownership. We conducted cognitive interviews to determine face validity of the scale items. Our finalized scale measures ownership's key constructs: advocacy, responsibility, accountability, follow-through, knowledge, communication, initiative, continuity of care, autonomy, and perceived ownership. We distributed an online, anonymous, 46-question survey to 219 residents; 192 residents completed the survey; and 166 responses were included in the analysis. We calculated Cronbach's α to determine the scale's internal consistency. Exploratory factor analysis was used to explore possible subscales. We examined construct validity using bivariate and correlational analysis.Key resultsThe 15-item ownership scale demonstrated good internal consistency (Cronbach's α = 0.89). We identified three possible subscales corresponding to assertiveness, being the "go-to" person, and diligence. Training level and prior intensive care unit experience significantly predicted ownership (p < 0.01). There was no significant relationship between ownership and age, gender, inpatient service type, call schedule, patient turnover, or supervisory experience of the attending physician. We found a significant negative correlation between ownership and perceived degree of burnout (r = - 0.33), depression (r = - 0.24), detachment (r = - 0.35), and frustration (r = - 0.31) and a significant positive association between ownership and fulfillment (r = 0.37) and happiness (r = 0.36).ConclusionWe developed an instrument to quantify patient care ownership in residents. Our scale demonstrates good internal consistency and preliminary evidence of validity. With further validation, we expect this to be a valuable tool to evaluate interventions aimed at improving ownership.

Project description:BackgroundGuidelines for colorectal cancer screening recommend that patients be informed about options and be able to select preferred method of screening; however, there are no existing measures available to assess whether this happens.MethodsColorectal Cancer Screening Decision Quality Instrument (CRC-DQI) includes knowledge items and patients' goals and concerns. Items were generated through literature review and qualitative work with patients and providers. Hypotheses relating to the acceptability, feasibility, discriminant validity and retest reliability of the survey were examined using data from three studies: (1) 2X2 randomized study of participants recruited online, (2) cross-sectional sample of patients recruited in community health clinics, and (3) cross-sectional sample of providers recruited from American Medical Association Master file.Results338 participants were recruited online, 94 participants were recruited from community health centers, and 115 physicians were recruited. The CRC-DQI was feasible and acceptable with low missing data and high response rates for both online and paper-based administrations. The knowledge score was able to discriminate between those who had seen a decision aid or not (84% vs. 64%, p < 0.001) and between providers, online patients and clinic patients (89% vs. 74% vs. 41%, p < 0.001 for all comparisons). The knowledge score and most of the goals had adequate retest reliability. About half of the participants received a test that matched their goals (47% and 51% in online and clinic samples respectively). Many respondents who had never been screened had goals that indicated a preference for colonoscopy. A minority of respondents in the online (21%) and in clinic (2%) samples were both well informed and received a test that matched their goals.ConclusionsThe CRC-DQI demonstrated good psychometric properties in diverse samples, and across different modes of administration. Few respondents made high quality decisions about colon cancer screening.

Project description:ObjectiveStudy objectives were to develop a questionnaire to assess factors influencing pharmacists' adoption of prescribing (i.e., continuing, adapting or initiating therapy), describe use of pre-incentive and mixed mode survey, and establish survey psychometric properties.MethodsQuestions were developed based on prior qualitative research and Diffusion of Innovation theory. Expert review, cognitive testing, survey pilot, and main survey were used to test the questionnaire. Six content experts reviewed the questionnaire to establish face and content validity. Ten pharmacists from diverse practice settings were purposefully recruited for a cognitive interview to verify question readability. Content analysis was used to analyze the results. A pre-survey introduction letter with a monetary incentive was mailed via post to 100 (i.e. pilot) and 700 (i.e., main survey) randomly selected pharmacists. This was followed by an e-mail with a personalized link to the online questionnaire, e-mail reminders, and a telephone reminder if required. The psychometric properties of scales were evaluated with an exploratory factor analysis and Cronbach's alpha. Scale responses were described.ResultsEngagement of six experts and ten pharmacists clarified definitions (e.g., prescribing), terminology, recall periods, and response options for the 34-item response scale. Fifty-six pharmacists completed the online pilot survey. Based on this data, ambiguous questions and routing issues were addressed. Three hundred and seventy-eight pharmacists completed the online main survey for a response rate of 54.6%. The factors analysis resulted in 27 questions in eight scales: (1) self-efficacy, (2) support from practice environment, (3) support from interprofessional relationship, (4) impact on professionalism, (5) impact on patient care), (6) prescribing beliefs, (7) technical use of electronic health record (EHR) and (8) patient care use of the EHR. Prescribing beliefs and technical use of the EHR scales had low reliability while the remaining six scales had strong evidence for reliability and validity.ConclusionThrough a multi-stage process, a survey instrument was developed to capture pharmacists' perceptions of prescribing influences. This questionnaire may support future research to develop interventions to enhance adoption of prescribing and enhance direct patient care by pharmacists.

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Development and application of a survey instrument to measure collaboration among health care and social services organizations.

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Development and application of a survey instrument to measure collaboration among health care and social services organizations.

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