Communicative Access Measures for Stroke: Development and Evaluation of a Quality Improvement Tool

Area of Science:

• Health Services Research
• Quality Improvement Science
• Rehabilitation Medicine

Background:

• Stroke survivors often experience language disorders, such as aphasia, impacting their access to information and shared decision-making.
• Effective communication is crucial for quality care and patient engagement, yet tools to measure communicative access in stroke care are limited.

Purpose of the Study:

• To develop a systems-level quality improvement tool, the Communicative Access Measures for Stroke (CAMS), for stroke patients with language disorders.
• To evaluate the reliability and utility of the CAMS tool in healthcare settings.

Main Methods:

• The CAMS tool was developed using established survey guidelines, including item generation, reduction, formatting, and pilot testing.
• Reliability was assessed using kappa statistics and intraclass correlations with administrators, frontline staff, and patients with aphasia.

Main Results:

• The CAMS tool comprises three surveys for administrators, staff, and patients with aphasia.
• Reliability for administrator and staff surveys was moderate to high (kappa/ICCs .54-1.00), while patient survey reliability was generally lower (ICCs 0.4-0.6).

Conclusions:

• The CAMS tool demonstrates potential for providing valuable quality improvement data for healthcare facilities.
• Implementing CAMS can help facilities enhance communicative access and improve care for stroke patients with aphasia.