Measuring Care Transition Quality for Older Patients with Musculoskeletal Disorders

Abstract

The aim of the current study was to examine the ability of a performance measurement scale, the Care Transitions Measure (CTM) adequately to assess the quality of care transitions among a complex population of older musculoskeletal (MSK) rehabilitation patients. Fifteen older (aged 60+) patients with MSK disorders were recruited from two inpatient rehabilitation units. A telephone interview was conducted three to four weeks post-discharge; this included the CTM and global questions used for construct validation. To assess inter-rater reliability, the CTM was re-administered to ten subjects in a second interview six to ten days later. Participant comments were recorded in an effort to gauge how respondents understood and interpreted items. The CTM demonstrated acceptable inter-rater reliability for the overall score (intraclass correlation coefficient = 0.77; p = 0.03), in spite of only fair agreement for specific items. The internal consistency was high (Cronbach's alpha = 0.94). The construct validity was supported; however, qualitative data suggest that additional items should be considered for inclusion, and the need for revisions to the wording of the response options and some items. Although the CTM proved to be reliable for an MSK population, there is a need for modifications to improve the construct validity and utility of the CTM. Recommendations for scale improvement are made. The results of the present study support efforts to improve the outcomes of care transitions, care planning and the overall quality of life for older rehabilitation patients.