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Practical Information
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Instrument Name:
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Coordination Among Health Care Professionals (CAHCP)
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Instrument Description:
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Assesses modes of coordination among health care professionals. There are two constructs, programming and feedback. Since there are different kinds of assignments among health professional groups, three slightly different versions were administrated to nurses, surgeons and anesthesiologists in the previous study. (Ref: 1) In the version for nurses, there are 49 items including Coordination Strategies (26 items) and Staff Coordination (23 items), and background information is also inquired.
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Price:
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Free (Available through the Management Decision & Research Center)
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Administration Time:
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No information found.
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Publication Year:
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1995
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Item Readability:
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Nurse Version: Most items on Coordination Strategies Scale have about 5 words. Staff Coordination Scale (Feedback) has a Flesch-Kincaid Reading Level of 11.4 for items, and most items have about 10 words.
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Scale Format:
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Nurse Version: Fixed and some open-ended items for the Background Information Section, and a 5-point scale for the Coordination Strategies (Programming) and Staff Coordination (Feedback) scales.
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Administration Technique:
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Self-administrated questionnaire
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Scoring and Interpretation:
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Individual scores in each professional group are averaged to calculate the professional score, and then three professional scores in each service are averaged to determine the surgical service score. (Ref: 2) A higher score is considered as a higher coordination. (Ref: 1)
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Forms:
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There are slightly different versions for different health professional groups. The versions for nurse, anesthesiologists, and surgeons are reported. (Ref: 1)
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Research Contacts
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Instrument Developers:
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Martin P. Charns, Gary J. Young, Jennifer Daley, Shukri F. Khuri and William G. Henderson
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Instrument Development Location:
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Management Decision & Research Center
VA Medical Center (152-M)
150 South Huntington Avenue
Boston, MA 02130
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Instrument Developer Email:
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No information found.
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Instrument Developer Website:
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No information found.
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Annotated Bibliography
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1. Charns MP, Young G, Daley J, Khuri S, Henderson W. Coordination and patient care outcomes. In Kimberly, JR and E Minivielle (eds). The Quality Imperative. London: Imperial College Press, 2000.
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Purpose: To discuss coordination in surgical care with the data from the National Veterans Affairs Surgical Risk Study (NVASRS). |
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Sample: N = 7364 in 44 surgical services from the VA hospitals were participated for the survey part of NVASRS in 1995. There were 2555 surgeons (70.9% response rate), 467 anesthesiologists (73.0%), and 4342 nurses (74.3%). |
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Methods: As the first phase of NVASRS, 20 low and high surgical mortality and/or morbidity facilities were visited, and their coordination in surgical care was closely observed. After the observations, the survey was constructed and mailed to individuals in 44 participant surgical services. |
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Implications: Coordination was more strongly related to morbidity than to mortality in a surgical service. |
2. Young GJ, Charns MP, Daley J, Forbes MG, Henderson W, Khuri SF. Best practices for managing surgical services: the role of coordination. Health Care Manage Rev. 1997 Fall;22(4):72-81. [PMID: 9358262]
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Purpose: To study the coordination practices of surgical services in relation to patients’ outcomes. |
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Sample: 44 surgical services participated in the National Veterans Affairs Surgical Risk Study. N = 7364 (73.2% response rate) in 44 surgical services responded. This sample included n = 2555 (70.9%) surgeons, n = 467 (73.0%) anesthesiologists, and n = 4342 (74.3%) nurses. |
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Methods: Before constructing the instrument, 20 site-visits, focus groups and a pilot test were administrated. The constructed instrument was then mailed to the 44 participant surgical services. For obtaining psychometric properties, the returned survey was analyzed with a principal components analysis and multi-trait scaling. |
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Implications: The higher coordination groups demonstrated better clinical outcomes and perceived quality. |
3. Charns MP, editor. Coordination among health care professionals. Management research tools/Instrument: Meeting on management research in VA; 2002 Feb 15; Washington, DC. Boston: Management Decision and Research Center; 2002.
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Purpose: To briefly report on the instrument. The nurse version was included. |
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Factors and Norms
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Factor Analysis Work:
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A principal components analyses with varimax rotation for three versions was conducted. Results suggest two factors: Group and personal modes of feedback, and Programming. (Ref: 2)
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Normative Information Availability:
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The mean scores were reported as 2.77 for the Feedback scale and 2.37 for the Programming scale for N = 7,364. (Ref: 2)
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Reliability Evidence
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Test-retest:
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Correlations across a six-week pilot testing period were ranged from 0.68 to 0.93 during the pilot testing. (Ref: 2)
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Inter-rater:
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No information found.
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Internal Consistency:
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Cronbach’s alphas for the three versions was in the range of 0.68 and 0.87. (Ref: 2)
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Alternate Forms:
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No information found.
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Validity Evidence
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Construct/ Convergent/ Discriminant:
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Multi-trait scaling was conducted to assess convergent and discriminant validity. (Ref: 2)
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Criterion-related/ Concurrent/ Predictive:
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No information found.
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Content:
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No information found.
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Responsiveness Evidence:
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No information found.
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Scale Application in VA Populations:
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Yes. (Ref: 1-3)
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Scale Application in non-VA Populations:
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No information found.
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Comments
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This instrument targets communication issues in hospital floor management and caregiver decision-making, important constructs that clearly underlie patient safety. Unfortunately, there are many other constructs that underlie patient safety, so use of this instrument likely provides only a partial indication of areas for improvement. Still, the instrument is a step in the right direction in that it enables a systematic attempt at including measurable aspects of staff coordination in the overall formula for improved patient outcomes. It may also be useful as a stand-alone diagnostic indicator of staff-physician communication at a particular hospital.
Overall Usefulness for a Certain Population:
The instrument was developed and pilot-tested on a Veteran patient population: typically, white males near the middle of the educational and socioeconomic range. Women and racial/ethnic minorities are likely underrepresented (actual sample demographics are unavailable). Portions of the instrument are adapted from existing instruments that were developed and validated in critical care and general medical inpatient settings. The authors state that the adapted items are tailored “to the clinical and managerial characteristics of surgical services,” based on input from surgical staff focus groups.
Advantages:
The instrument is readily available, free of charge to all users. The extensive work that went into development and validation lends the scores a degree of credibility not often seen with context-specific instruments. There are no reports of criticism for excessive length, and the interpretability of the items seems adequate.
Disadvantages:
This is a highly context-specific instrument, so application to other patient populations and/or other medical unit types may require significant item adaptation. Moreover, no comparison data from other studies, in the surgical or any other context, is currently available from the literature.
Recommendation:
Users whose context of proposed instrument use closely parallels the context under which this instrument was developed may find this instrument helpful. Other potential users may wish to contact the developer or other psychometrics expert to determine whether and how the instrument may be modified to fit the context of their proposed use.
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Updates
No information found.
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