Nurse-Sensitive Measurement of Hospital Care Coordination
The objective of this research is to identify, develop, and test a new nurse-sensitive measure of care coordination. The research team takes the perspectives and tools of nursing, health systems engineering, and the social sciences and incorporates them into the challenge of measuring care coordination in a hospital setting. Specific aims of this research are to:
- Identify key care coordination activities carried out by nurses in the hospital.
- Develop indicators to measure these care coordination activities.
- Test the performance of the new care coordination measure using National Quality Forum (NQF) criteria for quality performance measures.
In Crossing the Quality Chasm (2001), the Institute of Medicine identified care coordination as one of the essential components of an effective and safe healthcare system. Coordination of care is particularly important in the hospital setting where patients go through a complex sequence of events (i.e. admission, diagnostic testing, treatment, discharge) orchestrated by many different professionals in an unfamiliar and stressful environment.
Previous research conceptualizing, measuring, and attempting to link care coordination to quality outcomes has shown that it is a complex and multidimensional process. Current measures of care coordination reflect limited aspects of its complexity and have not clearly differentiated between the process of care coordination and other related processes like communication, cooperation, continuity, collaboration, and integration.
Our approach incorporates new conceptual as well as methodological strategies that are necessary to assure that the measure of care coordination: (1) begins to capture the complexity of the concept; (2) is sensitive to nursing actions; (3) meets NQF criteria for soundness and feasibility; and (4) may be used for quality improvement and assist in the design of technology to support effective care coordination processes.
The research involves participation from Emory Healthcare, Crawford Long, Saint Joseph Hospital, and the Veterans Administration Hospital, all in Atlanta.
Sponsor: Robert Wood Johnson Foundation