As providers of health care face the multiple challenges of today's health care environment, many believe that integrated delivery systems promise the structure needed to provide high-quality, cost-efficient care. They make structural and process changes with the expectation that those changes will improve system performance. But few systems actually measure progress in creating an integrated system. This article describes one health care system's strategy for introducing organizational measures to create an integrated system scorecard and focuses on the development, results, and use of the staff survey. The survey provides reliable indicators of system integration. Linking the survey results with network performance measures, in turn, provides managers with tools for judging whether system integration is associated with improved system performance.
This study aimed to provide further validity evidence for the KCES by analyzing data collected from multiple administrations of the KCES along with cognitive interviews of students in pharmacy and nursing programs to identify revisions of the Kiersma-Chen Empathy Scale: The KCES-Revised (KCES-R). Methods. De-identified data from previous KCES administrations were used for scale evaluation. Response process validity evidence was enhanced through cognitive interviews with 20 pre-pharmacy/pharmacy students at Cedarville University. After survey revisions, the cognitive interview process was repeated with 10 University of Wyoming nursing students.Results. Based on psychometric data and cognitive interviews, the KCES was revised as follows: (1) key components of cognitive and affective empathy were retained, (2) scaling was changed to reflect necessity and empathy ability, (3) negatively-worded items were removed, and (4) instrument was changed to two parallel subscales.
Conclusion.This study used data from thousands of geographically and professionally diverse samples. Based on potential problems identified in quantitative analyses, cognitive interviews with nursing and pharmacy students were conducted, and modifications to the KCES were made. Further psychometric validation is needed regarding the KCES-R.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.