Care Coordination Measures Atlas

Measure #17c. Primary Care Assessment Tool – Facility Expanded Edition (PCAT – FE)

Care Coordination Measure Mapping Table

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Primary Care Assessment Tool – Facility Expanded Edition (PCAT — FE)

Purpose: To measure primary care quality and the extent to which it meets consumer needs, as identified from the facility perspective.

Format/Data Source: 153-item survey with coverage across 4 domains of primary care: (1) longitudinality, (2) accessibility, (3) comprehensiveness, and (4) coordination. Relevant subtopics include: (C) first contact – access, (D) ongoing care, (E) coordination, (F) coordination – information systems, (G) comprehensiveness – services available, (H) comprehensiveness – services provided, (I) family-centeredness, (J) community orientation, (K) culturally competent, and Other. Some questions are designated as specifically related to care coordination. However, other items in other domains may be relevant to care coordination, although they are not explicitly categorized as measuring care coordination. Responses provided on a Likert scale.

Date: Measure published in 1998.¹

Perspective: System Representative(s)

Measure Item Mapping:

• Communicate:
  • Between health care professional(s) and patient/family: E7
• Interpersonal communication:
  • Between health care professional(s) and patient/family: C4, D2-D4, D6, E8, E12, I1, I4-I10
• Information transfer:
  • Between health care professional(s) and patient/family: D10, E1, F1-F4, I2
  • Across health care teams or settings: E10, E11
• Facilitate transitions:
  • Across settings: E9
• Assess needs and goals: D7, D9, E8, I1, I11-I14
• Monitor, follow up, and respond to change: C8, E7, E11, E12, F7
• Support self-management goals: G1-G25, G25, H1-H18
• Align resources with patient and population needs: C1-C9, I3, J1, J4-J9, K2-10
• Health care home: I4, D1
• Medication management: D13, F8, H7
• Health IT-enabled coordination: I3

Development and Testing: No testing was described in the sources identified. However, testing information is available for other versions.^{1, 2}

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: Based on a framework of primary care.³

Past or Validated Applications:

• Setting: Primary care family practices in the United States; adapted and translated for use in other countries (go to notes below).
• Population: Primary care patients
• Level of evaluation: System

Notes:

• All instrument items are available online.¹
• This instrument contains 153 items; 114 were mapped.
• There are 4 expanded versions of this instrument addressing 4 perspectives: (1) child, (2) adult, (3) facility, and (4) physician. There are 4 short versions for each of the 4 perspectives as well.
• The PCAT-FE uses a majority of the same items across the same domains as the PCAT-PE.
• Versions of the PCAT tools are also available in Spanish, Catalan, Portuguese, Mandarin Chinese (both People's Republic of China and Taiwan), and Korean.¹
• The PCAT is in the process of being computerized, in administration as well as scoring, for widespread use around the world, including especially Southeast Asia, the Gulf States, several countries in Europe, South Africa, several countries in Latin America (especially Brazil and Uruguay), China and Hong Kong, and others. (B. Starfield, personal communication, September 8, 2010).
• For further information regarding these measures, please visit the Web site, which provides detailed instructions and implementation use.¹

Sources:

1. Johns Hopkins University Bloomberg School of Public Health. Available at: http://www.jhsph.edu/pcpc/pca_tools.html. Accessed: 20 September 2010.
2. Shi LY, Starfield BH, Xu J. Validating the Adult Primary Care Assessment Tool. J Fam Pract 2001;50:161.
3. Starfield B. Primary care: concept, evaluation, and policy. New York: Oxford University Press; 1992.
4. Starfield B, Cassady C, Nanda J, et al. Consumer experiences and provider perceptions of the quality of primary care: implications for managed care. J Fam Pract 1998;46:216-26.

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Measure #17d. Primary Care Assessment Tool – Provider Expanded Edition (PCAT – PE)

Care Coordination Measure Mapping Table

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Primary Care Assessment Tool – Provider Expanded Edition (PCAT – PE)

Purpose: To measure primary care quality and the extent to which it meets consumer needs, as identified from the provider perspective.

Format/Data Source: 153-item survey with coverage across 4 domains of primary care: (1) longitudinality, (2) accessibility, (3) comprehensiveness, and (4) coordination. Relevant subtopics include: (C) first contact – access, (D) ongoing care, (E) coordination, (F) coordination – information systems, (G) comprehensiveness – services available, (H) comprehensiveness – services provided, (I) family-centeredness, (J) community orientation, (K) culturally competent, and Other.

Date: Measure published in 1998.¹

Perspective: Health Care Professional(s)

Measure Item Mapping:

• Communicate:
  • Between health care professional(s) and patient/family: E7
• Interpersonal communication:
  • Between health care professional(s) and patient/family: C4, D2-D4, D6, E8, E12, I1, I4-I10
• Information transfer:
  • Between health care professional(s) and patient/family: D10, E1, F1-F4, I2
  • Across health care teams or settings: E10, E11
• Facilitate transitions:
  • Across settings: E9
• Assess needs and goals: D7, D9, E8, I1, I11-I14
• Monitor, follow up, and respond to change: C8, E7, E11, E12, F7
• Support self-management goals: G1-G25, G25, H1-H18
• Align resources with patient and population needs: C1-C9, I3, J1, J4-J9, K2-10
• Health care home: I4, D1
• Medication management: D13, F8, H7
• Health IT-enabled coordination: I3

Development and Testing: No testing was described in the sources identified. However, testing information is available for other versions.^{1, 2}

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: Based on a framework of primary care.³

Past or Validated Applications:

• Setting: Primary care family practices in the United States; adapted and translated for use in other countries (go to notes below).
• Population: Primary care patients
• Level of evaluation: Health Care Professional(s)

Notes:

• All instrument items are available online.¹
• This instrument contains 153 items; 114 were mapped.
• There are 4 expanded versions of this instrument addressing 4 perspectives: (1) child, (2) adult, (3) facility, and (4) physician. There are 4 short versions for each of the 4 perspectives as well.
• The PCAT-FE uses a majority of the same items across the same domains as the PCAT-PE.
• Versions of the PCAT tools are also available in Spanish, Catalan, Portuguese, Mandarin Chinese (both People's Republic of China and Taiwan), and Korean.¹
• The PCAT is in the process of being computerized, in administration as well as scoring, for widespread use around the world, including especially Southeast Asia, the Gulf States, several countries in Europe, South Africa, several countries in Latin America (especially Brazil and Uruguay), China and Hong Kong, and others. (B. Starfield, personal communication, September 8, 2010).
• For further information regarding these measures, please visit the Web site, which provides detailed instructions and implementation use.¹

Sources:

1. Johns Hopkins University Bloomberg School of Public Health. Available at: http://www.jhsph.edu/pcpc/pca_tools.html. Accessed: 20 September 2010.
2. Shi LY, Starfield BH, Xu J. Validating the Adult Primary Care Assessment Tool. J Fam Pract 2001;50:161.
3. Starfield B. Primary care: concept, evaluation, and policy. New York: Oxford University Press; 1992.
4. Starfield B, Cassady C, Nanda J, et al. Consumer experiences and provider perceptions of the quality of primary care: implications for managed care. J Fam Pract 1998;46:216-26.

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Measure #18. Physician-Pharmacist Collaboration Instrument (PPCI)

Care Coordination Measure Mapping Table

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Physician-Pharmacist Collaboration Instrument (PPCI)

Purpose: To assess physician-pharmacist collaborative relationships across three domains: trustworthiness; role specification; relationship initiation.

Surveys can be directed at physicians and pharmacists respectively: questions are identical with provider title (physician/pharmacist) interchanged depending on the study population.

Format/Data Source: 14-item survey that consists of 3 domains of collaboration: (1) trustworthiness, (2) role specification, and (3) relationship initiation.

Date: Measure published in 2005.¹

Perspective: Health Care Professional(s)

Measure Item Mapping:

• Establish accountability or negotiate responsibility: 1, 5-8
• Communicate:
  • Interpersonal communication:
    • Across health care teams or settings: 3, 11
  • Information transfer:
    • Across health care teams or settings: 13
• Teamwork focused on coordination: 9, 12
• Medication management: 7, 8

Development and Testing: Testing of an initial 27-item version was conducted using results from 340 surveys. Principal component analysis was used to assess the structure and uncover underlying dimensions of the initial instrument. Items were evaluated for inclusion or exclusion and subsequently refined into a 14-item instrument. Validity and reliability were established for the 14-item version of the PPCI based on confirmatory factor analysis and Cronbach's alpha scores, respectively. The authors caution that the survey may not reflect interactions for physicians working with more than 1 pharmacist. The 14-item version is preferred over the 26-item version on the basis of brevity and similar psychometric properties.¹ The sensitivity of the instrument was established through a randomized, intervention trial.²

Link to Outcomes or Health System Characteristics: None described in the sources identified.

Logic Model/Conceptual Framework: The authors developed a theoretical model of physician-pharmacist collaborative working relationships.³

Past or Validated Applications:

• Setting: Not specific
• Population: Physicians and pharmacists
• Level of evaluation: Health Care Professional(s)

Notes:

• The original measure did not have individual items numbered. In order to properly reference specific items within this profile, all instrument items were consecutively numbered. The instrument was provided by the corresponding author upon request (A.J. Zillich, personal communication, September 9, 2010).
• This instrument contains 14 items; 10 were mapped.

Sources:

1. Zillich AJ, Doucette WR, Carter BL, et al. Development and initial validation of an instrument to measure physician-pharmacist collaboration from the physician perspective. Value Health 2005;8(1):59-66.
2. Zillich AJ, Milchak JL, Carter BL, et al. Utility of a questionnaire to measure physician/pharmacist collaborative relationships. J Am Pharm Assoc 2006;46:453-58.
3. McDonough R, Doucette W. A conceptual framework for collaborative working relationships between pharmacists and physicians. J Am Pharm Assoc 2001;41:682-92.
4. Zillich AJ, McDonough RP, Carter BL, et al. Influential characteristics of physician/pharmacist collaborative relationships. Ann Pharmacother 2004;38:764-70.

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Measure #19. Readiness for the Patient-Centered Medical Home

Care Coordination Measure Mapping Table

Legend:
■ = ≥ 3 corresponding measure items
□ = 1-2 corresponding measure items

Readiness for the Patient-Centered Medical Home

Purpose: To measure the prevalence of recommended capabilities for medical home practices.

Format/Data Source: 13-item survey that addresses 13 structural capabilities across four main domains: (1) patient assistance and reminders, (2) culture of quality, (3) enhanced access, and (4) electronic health records.

Date: Measure published in 2008.¹

Perspective: System Representative(s)

Measure Item Mapping:

• Monitor, follow up, and respond to change: 2-5
• Support self-management goals: 1
• Align resources with patient and population needs: 10-12
• Health care home: 1-13
• Health IT-enabled coordination: 13

Development and Testing: The survey is based on evidence and findings from previously published literature, as well as existing surveys of physician group characteristics. It was revised from its original version to improve validity after cognitive testing by physicians was completed.¹

Link to Outcomes or Health System Characteristics: A survey of 308 adult primary care practices in Massachusetts revealed that larger and network-affiliated practices were more likely than smaller, non-affiliated practices to have implemented recommended medical home components.¹

Logic Model/Conceptual Framework: National Committee for Quality Assurance (NCQA) Standards for a Patient-Centered Medical Home.¹

Past or Validated Applications:

• Setting: Adult primary care practices in the United States
• Population: Physicians and their practices
• Level of evaluation: System; Practice

Notes:

• All instrument items are located in the Appendix of the source article.¹
• This instrument contains 13 items; all 13 were mapped.

Sources:

1. Friedberg MW, Safran DG, Coltin KL, et al. Readiness for the patient-centered medical home: Structural capabilities of Massachusetts primary care practices. J Gen Int Med 2008;24(2):162-9.