The Key Driver Implementation Scale (KDIS) for practice facilitators: Psychometric testing in the "Southeastern collaboration to improve blood pressure control" trial.
The Key Driver Implementation Scale (KDIS) for practice facilitators: Psychometric testing in the "Southeastern collaboration to improve blood pressure control" trial.
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DOI：
10.1371/journal.pone.0272816
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发表时间：
2022
期刊：
影响因子：
3.7
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中科院分区：
文献类型：
--
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实践促进者（PFs）为初级保健实践提供量身定制的支持，以提高护理质量。PFs经常使用“关键驱动实施量表”（KDIS）来衡量实践实施慢性护理模型质量改进活动的程度，但该量表的心理测量属性尚未被调查。我们检验了东南合作改善血压控制试验中KDIS项目的结构效度、信度、下限和上限效应，并进行了纵向趋势检验。KDIS项目评估实践的实施进展：临床信息系统（使用自己的数据来推动变革）；标准化护理程序；优化团队关怀；患者自我管理支持；以及领导的支持。我们用多水平验证性因子分析（CFA）评估结构效度和估计信度。趋势测试检查KDIS项目是否随着时间的推移而增加，并估计将实践移动到最高响应选项所需的预期月数。PFs在12个月内完成了32个初级保健实践的每月KDIS评分，共产生384项观察结果。数据拟合为一维CFA模型；然而，参数拟合是适度的，可以改进。信度为0.70。实践在第5个月开始在最高水平上开始得分，表明低可变性。KDIS项目确实在12个月内显示了上升趋势（所有p < .001），表明实践越来越多地实现关键活动。标准化护理流程的预期时间为9.1个月，临床信息系统的预期时间为10.2个月，自我管理支持的预期时间为12.6个月，领导力的预期时间为13.1个月，优化团队护理的预期时间为14.3个月。KDIS项目显示出可接受的可靠性，但需要在更大的样本量中进行工作，以确定是否正在测量两组或更多组的执行活动，而不是一组。
Practice facilitators (PFs) provide tailored support to primary care practices to improve the quality of care delivery. Often used by PFs, the “Key Driver Implementation Scale” (KDIS) measures the degree to which a practice implements quality improvement activities from the Chronic Care Model, but the scale’s psychometric properties have not been investigated. We examined construct validity, reliability, floor and ceiling effects, and a longitudinal trend test of the KDIS items in the Southeastern Collaboration to Improve Blood Pressure Control trial. The KDIS items assess a practice’s progress toward implementing: a clinical information system (using their own data to drive change); standardized care processes; optimized team care; patient self-management support; and leadership support. We assessed construct validity and estimated reliability with a multilevel confirmatory factor analysis (CFA). A trend test examined whether the KDIS items increased over time and estimated the expected number of months needed to move a practice to the highest response options. PFs completed monthly KDIS ratings over 12 months for 32 primary care practices, yielding a total of 384 observations. Data was fitted to a unidimensional CFA model; however, parameter fit was modest and could be improved. Reliability was 0.70. Practices started scoring at the highest levels beginning in month 5, indicating low variability. The KDIS items did show an upward trend over 12 months (all p < .001), indicating that practices were increasingly implementing key activities. The expected time to move a practice to the highest response category was 9.1 months for standardized care processes, 10.2 for clinical information system, 12.6 for self-management support, 13.1 for leadership, and 14.3 months for optimized team care. The KDIS items showed acceptable reliability, but work is needed in larger sample sizes to determine if two or more groups of implementation activities are being measured rather than one.
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DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
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通讯作者：
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影响因子：
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影响因子：
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