Table 1 Overview of study methods, by objective
From: Linking clinician interaction and coordination to clinical performance in Patient-Aligned Care Teams
Element | Objective 1 | Objective 2 | Objective 3 |
|---|---|---|---|
Objective | (a) Characterize coordination practices utilized by PACTs and (b) examine their association with clinical performance | Determine the level of coordinative complexity required for each outpatient clinical performance measure | Evaluate the role of measure complexity in how PACT coordination measures relate to EPRP performance measures |
Design | Web-based survey of coordination practices | Expert ratings of EPRP measures on coordinative complexity, obtained via functional job analysis (FJA) | Statistical analysis of the impact of coordinative complexity on the association between coordination practices and clinical performance |
Participants | Initial validation sample will include teamlet members of 500 PACTs. Full survey deployment will include teamlet members of 1600 PACTs nationwide | 6–8 3rd or 4th year residents in VA Primary Care rotations, to serve as subject matter experts (SME) | None. This aim combines datasets from aims 1 and 2 |
Measures | Outcome: clinical performance, measured by 25 outpatient EPRP measures | Clinical performance: same as objective 1b | Outcome: clinical performance, measured the same as in objectives 1b and 2 |
Predictors: coordination practices, measured via web-based survey developed for this project | Coordinative complexity: average Worker Interaction scale ratings for the set of tasks comprising each EPRP measure | Predictor: coordination, measured the same as in objective 1b | |
Covariate: PACT integration, calculated with PACT recognition metrics, available via the Patient-Aligned Care Teams Compass Cube | Coordinative complexity ratings: same as objective 2 | ||
Procedures | Survey development: coordination survey to be developed and piloted using small groups of PACT teamlet members (n = 6–8) | FJA focus groups: SMEs will generate FJA-style lists of task statements comprising the work required to perform each EPRP measure to standard | No new procedures, this aim is strictly analytical |
Survey deployment: web-based deployment via SurveyMonkey, using recruitment strategy recommended by Dillman | Coordinative complexity rating: research team will rate each task on the worker interaction FJA scale | ||
Data analysis | (a) To evaluate O&B’s measurement model: series of two-level CFAs, followed by EFAs (where fit is unacceptable) and Cronbach’s alphas. To evaluate O&B’s structural model: structural equations modeling (b) hierarchical linear models with PACT level coordination as predictors of clinical performance | No hypothesis tests planned; descriptive statistics for coordinative complexity and number of tasks per EPRP measure | Same as objective 1b, except that we will conduct hierarchical linear models separately for higher versus lower complexity measures and will then compare regression coefficients between models |