Development of a Modified High-Value Care Rounding Tool

Area of Science:

• Healthcare Quality Improvement
• Psychometric Evaluation
• Hospital Operations

Background:

• Engaging patients and families in high-value care (HVC) during hospital rounds is crucial for effective healthcare delivery.
• The High-Value Care Rounding Tool (HVC-RT) is the sole published instrument for assessing provider performance in HVC rounding.
• The original HVC-RT requires psychometric refinement due to its 3-domain, 10-measure structure and limited quantitative validation.

Purpose of the Study:

• To psychometrically evaluate the existing High-Value Care Rounding Tool (HVC-RT).
• To explore and validate a data-derived, modified structure for the HVC-RT.
• To enhance the tool's psychometric properties and clinical utility.

Main Methods:

• A content validation study utilizing psychometric testing on 371 HVC-RT rounding encounters from a pediatric hospitalist service.
• Polychoric correlation analysis was employed to identify and eliminate collinear measures.
• Exploratory Factor Analysis (EFA) was conducted to derive a new domain and measure structure, followed by reliability testing using Kuder-Richardson (KR-20).

Main Results:

• The original 3-domain, 10-measure HVC-RT was reduced and restructured into a 2-domain, 7-measure construct via EFA.
• The new structure comprises domains for 'cost-effective care' and 'individualized hospital care'.
• Statistical indicators (KMO, RMS residual, factor loading, communality) demonstrated excellent psychometric properties, and KR-20 confirmed adequate domain reliability.

Conclusions:

• Psychometric analysis supports the restructuring of the original HVC-RT.
• The study proposes a modified HVC-RT that is shorter and psychometrically derived.
• The modified HVC-RT exhibits acceptable reliability for assessing provider performance in high-value care.