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Development of a scientifically valid coordinated care path
R L Anders1, J S Tomai, R M Clute
1University of Hawaii, School of Nursing, Honolulu, USA. anders@hawaii.edu
Insights
A validated method for creating coordinated care paths was developed and scientifically validated. This approach ensures effective clinical guidelines for hospitals, improving patient care and potentially reducing costs.
Area of Science:
- Healthcare Management
- Clinical Pathway Development
- Health Services Research
Background:
- High costs and lengths of stay in hospitals necessitate innovative patient management strategies.
- Coordinated care paths offer a structured approach to managing clinical care for specific patient groups.
- Scientific validation of care path efficacy remains an under-researched area.
Purpose of the Study:
- To develop and scientifically validate a robust methodology for creating coordinated care paths applicable across diverse hospital settings.
- To establish a standardized process for the scientific development and validation of clinical guidelines.
Main Methods:
- A content validity methodology was employed for the validation process.
- A transdisciplinary team synthesized current research and best practices to formulate guidelines.
- Expert review using a four-point rating scale and Lynn's proportion of experts table determined path validity.
Main Results:
- The developed care path achieved a high instrument validation rate of 0.94 (151 out of 161 items validated).
- The instrument was validated as a whole by both local and national experts.
- No further modifications were recommended by the expert panel, indicating strong initial validity.
Conclusions:
- The presented content validity method provides a scientifically sound approach for developing and validating coordinated care paths.
- This validated methodology can be adapted for the creation of care paths for various diagnostic groups.
- The study successfully established a reliable instrument for clinical care management in hospitals.
Objective:
The goal of this study was to develop a method to scientifically create and validate a coordinated care path for use within any hospital setting.
Background:
In an attempt to reduce the costs associated with high-volume and high-risk diagnosis, attention was focused on reducing patients' length of stay in the hospital. A method to reduce length of stay uses a coordinated care path. A path is a guideline used to manage the clinical care of selected patients. The literature is relatively silent regarding studies that have scientifically validated the use of these paths.
Methods:
This project used a content validity method to validate the care path. Using current research findings, best practice standards both locally and nationally, a transdisciplinary team developed practice guidelines that included sequencing, timing of interventions, and expected patient outcomes. The path was rated by local and national experts using a four-point rating scale. Using Lynn's proportion of experts table computations, the validity of the path and each of its components was determined.
Results:
Of 161 items on the care path, 10 were not validated. The experts validated the instrument as a whole. Of the 161 items, 151 were validated. This is an instrument validation rate of 0.94. No additional changes or modifications to the path were suggested by the experts. The transdisciplinary team addressed the nonvalidated items. This method can be used to develop other coordinated paths for other diagnostic groups.