Evidence map›Paper›PMID 35128641›Full record

ArticleHealth services research2022

Development and testing of a survey measure of organizational perinatal patient-centered care culture.

Sara C Handley, Molly Passarella, Ashley E Martin, Scott A Lorch, Sindhu K Srinivas, Ingrid M Nembhard

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Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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6 authors.

Sara C HandleyDivision of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia and the Perelman School of Medicine-University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-8436-4351
Molly PassarellaDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Ashley E MartinDepartment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Scott A LorchDivision of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia and the Perelman School of Medicine-University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-3855-6752
Sindhu K SrinivasLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ingrid M NembhardLeonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-7696-4832

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop and test a measure of patient-centered care (PCC) culture in hospital-based perinatal care. DATA SOURCES: Data were obtained from US perinatal hospitals: one provided survey development data and 14 contributed data for survey testing. STUDY

designWe used qualitative and quantitative methods to develop the mother-infant centered care (MICC) culture survey. Qualitative methods included observation, focus group, interviews, and expert consultations to adapt items from other settings and create new items capturing dimensions of PCC articulated by The Commonwealth Fund. We quantitatively assessed survey psychometric properties using reliability (Cronbach's α and Pearson correlation coefficients) and validity (exploratory and confirmatory factor analysis [CFA]) statistics, and refined the survey. After confirming aggregation suitability (ICCs), we calculated "MICC culture scores" at the individual, unit, and hospital level and assessed associations between scores and survey-collected, staff-reported outcomes to evaluate concurrent validity. DATA COLLECTION: Survey development included 12 site-visit observations, one semi-structured focus group (five participants), two semi-structured interviews, five cognitive interviews, and three expert consultations. Survey testing used online surveys administered to obstetric and neonatal unit staff (N = 316). PRINCIPAL

findingsUsing responses from 10 hospitals with ≥4 responses from both units (n = 240), the 20-item MICC culture survey demonstrated reliability (Cronbach's α = 0.95) while capturing all PCC dimensions (subscale Cronbach's α = 0.72-0.87). CFA showed validity through goodness-of-fit (overall chi-square = 214 [p-value = 0.012], SRMR = 0.056, RMSEA = 0.041, CFI = 0.97, and TLI = 0.96). Aggregation statistics (ICCs < 0.05) justify unit- and hospital-level aggregation. Demonstrating preliminary validity, individual-, unit-, and hospital-level MICC culture scores were associated with all outcomes (satisfaction with care provided, within-unit team effectiveness, and relational coordination [RC] between units) (p-values < 0.05), except for neonatal unit scores and RC (p-value = 0.11).

conclusionsThe MICC culture survey is a psychometrically sound measure of PCC culture for hospital-based perinatal care. Survey scores are associated with staff-reported outcomes. Future studies with patient outcomes will aid identification of improvement opportunities in perinatal care.

Indexed as

Organizational CulturePatient-Centered CareHumansInfant, NewbornPsychometricsReproducibility of ResultsSurveys and Questionnaireschildbirthhospitalizationinpatientsmother-infantorganizational culturepatient-centered careperinatal caresurveys and questionnaires

Identifiers

PMID35128641
PMCPMC9264452

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