Reliability and validity of the Veterans Administration Mobility Screening and Solutions Tool

Area of Science:

• Healthcare technology assessment
• Clinical decision support systems
• Patient safety and mobility

Background:

• The Veterans Administration Mobility Screening and Solutions Tool (VA MSST) was developed to standardize patient mobility assessment.
• It aims to provide real-time clinical decision support for safe patient handling and mobility (SPHM) equipment.
• The tool functions as a common language, facilitating communication across healthcare disciplines and settings.

Purpose of the Study:

• To evaluate the interrater reliability and validity of the VA MSST.
• To assess the tool's effectiveness in screening safe mobility levels and guiding SPHM equipment selection.
• To determine if the VA MSST can be reliably used by diverse healthcare professionals.

Main Methods:

• The VA MSST features four levels, differentiating equipment needs based on patient independence.
• Scenarios were developed for interrater reliability and validity testing.
• The tool underwent iterative review and validation by over 200 healthcare workers from various disciplines, including nurses, therapists, and technicians, using simulation videos and an online survey.

Main Results:

• Excellent interrater reliability was demonstrated, with Krippendorff's alpha of 0.998.
• 82% of raters found the VA MSST instructions clear and understandable.
• High concurrent validity was shown through strong correlation with experienced physical therapists' assessments (r=0.99), and good construct validity was indicated by the tool's ability to discriminate mobility levels.

Conclusions:

• The VA MSST is an evidence-based flowchart tool with excellent interrater reliability across diverse healthcare settings and disciplines.
• It possesses strong face, content, concurrent, and construct validity.
• The VA MSST effectively supports clinical decision-making for safe patient mobility and handling.