Coordination Of Processes Research Articles

From local to the whole: understanding construction projects as multiteam systems

PurposeIn today's digital and post-pandemic era, construction teams can span their boundary to obtain important resources and support in computer-mediated ways. However, the benefits of computer-mediated team boundary spanning (TBS) are mostly assumed. Empirical evidence for these benefits is in lack. Thus, this study attempts to investigate the influence of computer-mediated (instant messaging in this study) TBS on construction project performance and the underlying mechanism.Design/methodology/approachFrom the multiteam system (MTS) perspective, this study employs the input-process-outcome (IPO) framework and coordination theory to explore the influence of instant messaging-based team boundary spanning (IMTBS) on construction project coordination processes and project performance. A theoretical model is built and validated with a survey involving 206 construction projects.FindingsResults show that IMTBS positively affects knowledge integration and project coordination, but negatively affects project commitment. The positive link between IMTBS and project performance is attributable to knowledge integration and project coordination. Further, project commitment is also found to negatively mediate the relationship between IMTBS and construction project performance.Originality/valueTo the best of the authors’ knowledge, this study is the first to empirically investigate the influence of TBS on construction project performance. As such, this study contributes to the literature on TBS in the construction field. In addition, the findings of this study unveil the double-edged characteristic of IMTBS, which should attract managers' attention. This also indicates that the form of TBS is a significant determinant of its effectiveness, which should attract scholars' attention in the future.

New DOCR coordination via non-conventional time curves to achieve bounded relay times

In this paper, the new coordination of directional overcurrent relays (DOCRs) is presented to obtain expected relay times. The objective of traditional DOCR coordination is to determine the shortest possible relay time, a non-limited minimization is considered. However, a functional dependence between relays is obtained due the sequence of operation between primary and backup functions, resulting in an uncertainty in the relay times. In the proposed method, the DOCRs are delimited in time intervals resulting in bounded coordination times. The conventional coordination criterion is not used hence there are no coordination pairs, since the commitment of each relay is that its time curve complies with the time intervals. This proposal avoids the incertitude in the relay times in the coordination process, very long or very short times that can affect the operation or safety of the electrical network. In the proposed method, the setting of each relay is stand-alone, the design of time curve must guarantee the relay times for each interval considered, non-conventional curves are used in this proposed. The results in the test systems show that the proposed method is feasible, obtaining the desired results.

Coordination‐behavior patterns of control crews in digital nuclear power plants during emergencies from a network perspective: An exploratory study

AbstractThis study aims to investigate the coordination‐behavior patterns of control crews in digital nuclear power plants (NPPs) during emergencies from a network perspective. We observed and coded 12 coordination processes (each from one crew) of handling simulated emergencies on a full‐scope dynamic simulator in Tianwan NPP of China. By calculating the proportion of coordination breakdowns and referring to the subjective evaluation of instructors, these control crews (all male) were classified into two performance levels (high and low). To compare the coordination‐behavior patterns between high‐ and low‐performing crews, we conducted social network analysis based on the number and direction of coordination behaviors. By examining intracrew relations in team coordination, this study indicated that high‐performing crews exhibited higher cohesion and more balanced behavioral patterns in team coordination than low‐performing ones. By investigating coordination‐behavior patterns from the hierarchical structure of relations in the team, this study revealed that high‐performing crews exhibited higher degree of team autonomy and self‐management among junior operators, as well as reactor operator (RO)‐centered pattern, whereas the low‐performing crews exhibited senior reactor operator‐centered pattern. For researchers, the results advance the understanding of the team coordination mechanism in NPP control rooms during emergencies and enrich team coordination theory in process control industries from the network perspective. In practice, this study suggested that the team coordination training of NPP control crews might be centered around junior operators (especially RO), with focuses on facilitating information sharing and mutual assistance between junior operators and enhancing the awareness of active cooperation of crew members. The results of the study provide nuclear instructors with practical reference to team coordination training and processes optimization.

Mesoscopic architecture enhances communication across the macaque connectome revealing structure-function correspondence in the brain.

Analyzing the brain in terms of organizational structures at intermediate scales provides an approach to unravel the complexity arising from interactions between its large number of components. Focusing on a wiring diagram that spans the cortex, basal ganglia, and thalamus of the macaque brain, we identify robust modules in the network that provide a mesoscopic-level description of its topological architecture. Surprisingly, we find that the modular architecture facilitates rapid communication across the network, instead of localizing activity as is typically expected in networks having community organization. By considering processes of diffusive spreading and coordination, we demonstrate that the specific pattern of inter- and intramodular connectivity in the network allows propagation to be even faster than equivalent randomized networks with or without modular structure. This pattern of connectivity is seen at different scales and is conserved across principal cortical divisions, as well as subcortical structures. Furthermore, we find that the physical proximity between areas is insufficient to explain the modular organization, as similar mesoscopic structures can be obtained even after factoring out the effect of distance constraints on the connectivity. By supplementing the topological information about the macaque connectome with physical locations, volumes, and functions of the constituent areas and analyzing this augmented dataset, we reveal a counterintuitive role played by the modular architecture of the brain in promoting global coordination of its activity. It suggests a possible explanation for the ubiquity of modularity in brain networks.

In Situ Imaging and Computational Modeling Reveal That Thiophene Complexation with Co(II)porphyrin/Graphite Is Highly Cooperative

Scanning tunneling microscopy (STM) was employed to quantitively investigate in situ binding of 3-phenyl thiophene (PhTh) to Co(II)octaethyl porphyrin (CoOEP) supported on highly ordered pyrolytic graphite (HOPG) in fluid solution. To our knowledge, this is the first single-molecule level study of a complexation reaction between a metalloporphyrin and a sulfur base at the solution/solid interface and one of the few examples of thiophene coordination with a d7 transition metal. Real-time imaging experiments revealed that PhTh binds reversibly to HOPG-supported CoOEP at room temperature. The coordination process increases with increasing PhTh concentration. The nearest-neighbor analysis of STM images indicates that the complexation reaction is cooperative. Because PhTh does not bind to CoOEP in solution, the STM results strongly suggest that the presence of HOPG is crucial to observe ligand binding and cooperativity in this system. Periodic plane-wave density functional theory (DFT) computations corroborate that PhTh has low binding affinity toward CoOEP in solution but predict that the ligand can adsorb to CoOEP/HOPG through coordination with S atoms or interact through noncovalent π–π bonding with the porphyrin chromophore. Three possible structures were considered, and DFT theory was used to calculate binding energies and free energies. In solution and on the HOPG surface both a π–π configuration and a η1(S) configuration have similar computed energies. The η1(S) structure shows the largest stabilization in going from the vapor to adsorbed on HOPG. We also show that statistical analysis of nearest neighbors is more sensitive to cooperative binding than is fitting with the Temkin or Langmuir isotherm. The implication is that isotherm fitting alone is insufficient for identifying cooperative binding on surfaces.

Coordination processes in partnerships between German governmental organizations and German sports federations in jointly implemented SDP projects.

Sports and physical activity are increasingly used as instruments of development policy. Within this field of sport for development and peace (SDP), one can observe a large number of partnerships between national governmental organizations and national sport federations. These are particularly important although these organizations pursue different core objectives with their SDP engagement. The aim of this qualitative study is to analyze how German governmental organizations and sports federations coordinate jointly managed SDP projects. Against the backdrop of systems theory, we conducted interviews with participants from relevant organizations. The qualitative content analysis revealed that inter-organizational coordination takes place partly in hierarchical and partly in network-based structures. The results show complex patterns between the participating organizations which gain varying degrees of influence on the SDP projects and seek to get specific resources through the cooperations. These should be taken into consideration when designing SDP projects to build stable cooperations that bring all the participating organizations an added value.

Evaluating the Effectiveness of BIM-based Virtual Reality for Coordinating the Design Disciplines in a Building Renovation Project

The coordination process plays a vital role in construction projects during the design phase when interferences and clashes between design systems are identified to reduce the risk of costly reworks. Despite the fact that coordination has been studied commonly in BIM research, limited research has explored the impact of virtual reality (VR) to understand how it can enhance the process. This research study examined the effectiveness of coordination processes in a building renovation project following an innovative approach based on virtual environments (3D-BIM VR) compared to the conventional approach (2D CAD). This research uses the Cyclotron Charette Test method to analyse both approaches in terms of accuracy, speed, and usability. Fifteen participants from engineering backgrounds participated in the prototype testing divided into two experiments. The first experiment involved visually identifying clashes from multiple 2D CAD drawings, while the second involved visually identifying clashes from 3D-BIM-based VR models. The results showed that the virtual reality environment not only helped uncover clashes quickly but also made it more accurate and helpful. A further finding from this research indicates that motion sickness hinders users’’ participation in VR environments. Finally, future research pathways are discussed to improve the coordination process using VR technology

THỰC TRẠNG PHỐI HỢP NHÀ TRƯỜNG VÀ GIA ĐÌNH TRONG GIÁO DỤC TÍNH TỰ LẬP CHO TRẺ 3 - 4 TUỔI TẠI MỘT SỐ TRƯỜNG MẦM NON HÀ NỘI

Independence is one of the important qualities that should be taught from an early age. In order to teach independence to 3-4-year-olds to be effective, it is necessary to coordinate between the school and the family. The survey results show that this cooperation still has many limitations: the content of education for independence has not been paid attention to by teachers and parents, and the forms of cooperation have not been diversified. The process of coordination is mainly influenced by influencing factors such as teachers' awareness of the role of independent education in children's development, and parents' consent to cooperation work. independence education for children. Some measures are proposed to improve the situation of school-family coordination in educating children on independence.

Interfacing between FM and project phases through digital processes and collaborative practices

Challenges and opportunities of creating value through information delivery from renovation projects to Facility Management is an ongoing issue for the built environment. Eight interviews were conducted with FM, project management and construction management involved in renovation projects to examine this issue closely. The finding support existing work from new project delivery in the need for ongoing coordination of information flows between projects and FM. However, there is less understanding on how this information is integrated into FM practices and the role of FM in project processes in creating long-term value of renovated buildings. The outcome is that there is a to incorporate FM into the current framework of project process as a continuous role to ensure FM knowledge is embedded in data systems. Both coordination processes and clear communication interactions is required to build meaning into data that can be adapted to different knowledge discipline bases working in different times and contexts across the building lifecycle. The research is relevant to practitioners and educators on illustrating how FM need to evolve and engage/be invited into projects decision-making that has long-term implication for FM services and digital systems throughout the building life-cycle.

Against Cure and Toward Access in Musical Engagement

In this paper, I reflect on my own experiences undergoing occupational therapy with musical elements in the United States in childhood for impairments related to physical coordination and visual processing. Although therapy involving music was by far the most enjoyable and least painful of the therapies and treatments I underwent as a multiply-disabled child, it was still anchored in the language of removing my impairments and/or aligning me better with nondisabled norms. I build on the work of Robert Gross (incorporating the social model of disability into music therapy) and Emily Elaine Williams (the participatory model of accommodation enabling music for pleasure, not for therapy). I also draw on works in the autistic and cross-disability online spheres on the overmedicalization of disabled people’s leisure activities to argue that framing music as a possible agent of cure or normalization harmfully obscures the ways in which music can provide access and mitigate impairments when directed and controlled by the listener, rather than by the therapist. My paper will also contrast music as therapy (imposed by others) vs. music as access tool (self-imposed) via a playlist and corresponding analysis. Music is central to my overall engagement with the world, affecting everything from processing and describing emotions, to communicating, to aiding in sensory processing. By introducing music as an access tool, or even as a form of assistive technology, I aim to challenge the dominant framing of normalization in therapy involving music and shift the focus to affirming disabled ways of engaging with music.

Reducing Recurrence and Complications Related to Clostridioides difficile Infection: A Panel Discussion Summary.

The Centers for Disease Control and Prevention identifies Clostridioides difficile infection (CDI) as an urgent threat to people and health care systems. CDI leads to high health care utilizations and results in significantly reduced quality of life for patients. The high burden of disease is seen across all health care settings, outside of the hospital, in the community, and in younger people. Individuals with CDI transition from hospitals to long-term care facilities to the community, and management of these transitions can reduce the incidence of recurrence and rehospitalization. The most common cause of diarrhea occurring in a health care setting is Clostridioides difficile and is also the cause of antibiotic-associated colitis (L. C. McDonald, 2021). The infection results from a disruption in the microbial flora of the gastrointestinal tract, mostly after antibiotic use or other medications such as proton pump inhibitors (PPIs). As a result, infected individuals are colonized and shed the spores into the environment, exposing others-goals of treatment focus on reducing the exposure and individual susceptibility. Although the incidence of C. diff is stable, recurrence is increasing significantly, with severe complications also a concern. The increased incidence and potential for life-threatening conditions require reducing initial exposure, supporting prescribed treatment, and preventing recurrence. C. diff infection can be contracted in health care facilities and in the community. Case managers from nearly all practice settings may encounter patients with the infection. To avert the devastating complications of Clostridioides difficile infection, case managers play an essential role in the prevention of recurrence with education, advocacy of best practices, effective care coordination, and thorough transitions of care. Each recurrence of C. diff infection leaves the patient vulnerable to the potential for surgical intervention, sepsis, and death. Mitigating the risk for readmission and recurrence will enhance C. diff infection care, safety, and outcomes to improve a patient's health care journey and quality of life. Case managers need to take a primary role in the transition and care coordination processes, including patient and support system education, coordination of any postdischarge services, connection to providers, adherence support activities, and follow-up for improvement or changes in condition. Supportive adherence activities and prevention education can result in the avoidance of recurrence. Case managers are well-equipped to locate resources to assist those patients challenged with the cost of medications, inability to attend appointments, or access basic needs. Although not directly related to C. diff, these challenges contribute to recurrence and readmission. Mitigating risk for readmission and recurrence results in an improved quality of life.

Facile synthesis behavior and CO2 adsorption capacities of Zn-based metal organic framework prepared via a microchannel reactor

MOFs are traditionally synthesized via intermittent synthesis, but its synthesis process is time consuming. Furthermore, many organic solvents used in the synthesis of MOF materials severely pollute the environment. Therefore, in this work, different types of Zn-MOFs were synthesized using a microchannel reactor with various proportions of MeOH and H2O as solvents. Unlike the direct mixing method, the microchannel reactor could synthesize Zn-MOF structures under any solvent proportion, and different solvents had a great influence on Zn-MOF morphology. Density functional theory (DFT) calculations were conducted to explain why Zn-MOFs with varied morphologies could be synthesized in different solvents. The calculation results showed that 2-methylimidazole was easier to coordinate with the zinc ions in the MeOH solvent due to its low free energy; thus, it was easier to form three-dimensional structures. However, in the H2O solvent, growth stopped due to a sudden increase in free energy in the coordination process, so a two-dimensional structure appeared in the aqueous solution. Finally, Zn-MOFs with more mesoporous structures had better adsorption performance. At 1 atm and 298 K, MOF-FNP-MeOH and MOF-FNP-H2O performed the maximum CO2 adsorption capacity of 3.28 mmol·g−1 and 4.09 mmol·g−1, respectively.

Desenvolvimento sintático em produções escritas de crianças de 1.º ciclo

This article presents a study on the syntactic development of children attending the 1st cycle of basic education based on their writing. We seek to (i) identify which are the predominant clause articulation processes at an early stage of compositional writing from the connectors that emerge at this stage; (ii) determine if the clause articulation processes evidence syntactic knowledge about the coordination and subordination processes; and (iii) determine the progression in the use of connectors over the course of a school year in this initial phase of compositional writing. We analyzed a corpus with 156 narrative texts written by students at grade 2, and a second corpus with 126 texts of the same students at grade 3. Results show us that connectives used in coordinate structures are predominant in children’s writing, although we can identify different profiles of syntactic development. A comparison between the texts of grade 2 and grade 3 shows an increase both in terms of the quantity and the diversity of the connectives used. Subordination becomes a more consistently used process of clause articulation in the narrative texts analyzed, with some connectives becoming more frequent and others emerging in students’ writing.

Effect of TBP on the Coordination Process of Eu(III) with T2EHDGA: A Luminescence Spectroscopy Investigation

AbstractIn this report, we explore the precise responsibility of a phase modifier along with the prime ligand in the coordination process of Ln(III) ions using luminescence spectroscopic technique by taking Eu(III) as the probeing metal ion. A well accepted diglyoclamide (DGA) ligand: N,N,N’,N’‐ tetra(ethylhexyl)diglycolamide(T2EHDGA) was used as the prime extractant along with tri‐n‐butylphosphate (TBP) as the phase modifier. Meticulous investigations on Eu(III) complexation with T2EHDGA‐TBP binary mixture was pursued by employing luminescence spectroscopy with the systematic variation of the concentration of TBP in the ligating phase and initial concentration of Eu(III) in the feed phase. The dominancy of the LMCT band over that of the metal centered band signifies the structural difference in the ligands used in the study. The presence of TBP in the organic phase enhances the intensity of 5D0→7F2 and 5D0→7F0 transition. The excitation and emission patterns of the Eu(III)‐solvate species formed in the organic phase both in unirraditaed and irradiated conditions were found to be entirely different, which effectively corroborates the efficacy of the extracting phase. The asymmetry ratio (AR) and the life time data at each experimental conditions were ascertained to realize the coordination behavior of the Eu(III) complex in the organic phase.

Improving the socio-ecological fit in water governance by enhancing coordination of ecosystem services used

Water governance systems have evolved around the exploitation of provisioning ecosystem services. The overexploitation of provisioning and the degradation of regulating services have led to a decline in the capacity of ecosystems to provide any services at all. Decisions affecting water-related ecosystem services are often not made in the water sector. Governance that does not take into account ecological interdependencies lead to unsustainable use of resources. In such situations, one can speak of a misfit between interdependencies of ecosystem services and coordination processes that would allow addressing them. The article introduces an approach to identify such misfits and potential solutions to overcome them and applies the approach to case studies in Germany, South Africa and Iran. The context-sensitive analyses highlight factors that contribute to or even determine prevailing practices in water management. The fit with the pattern of ecosystem service uses was found to be higher for governance processes in practice (formal and informal) than for formal coordination instruments on paper. Actors may not lack opportunities to exchange but these are not translated into tangible coordination outcomes. To reduce trade-offs between the uses of ecosystem service, improved synergies are needed between formal and informal institutional settings. Instruments need to be tailored to local circumstances. Scope and effectiveness of local action may be limited by higher governance levels. The analyses have demonstrated that the path from improving social-ecological fit to achieving sustainability is long. Addressing institutional deficits requires transformational change rather than short-term measures for addressing isolated problems or crisis situations.

Implementation of a Dedicated Concurrent Chemotherapy and Radiation (C-XRT) Coordination Process can Result in Improved C-XRT Synchronization

<h3>Purpose/Objective(s)</h3> C-XRT has been shown to improve overall survival rates and local control for some cancer patients. The successful coordination of the start of chemotherapy and radiation is important to optimize treatment outcomes. Interprofessional teams are essential to providing best results¹. We hypothesized that developing a C-XRT coordination process that includes key stakeholders communicating about pertinent data elements would improve coordination of C-XRT. <h3>Materials/Methods</h3> Starting November 2019, we implemented a chemo-coordination group that involved chemotherapy and radiation nurses, dosimetry, and radiation therapists. A process was put in place utilizing both two electronic patient information management systems. This process began with a request to coordinate C-XRT initiated by the physician on the CT simulation order. This request would create an electronic notification to nursing to coordinate as well as notification to dosimetry and therapy to make them aware. The need for chemo-coordination was also displayed on departmental electronic dashboard. An in-basket was setup to allow nursing teams to communicate in the patient EMR. Nursing, dosimetry, and therapy would meet weekly to review current patient planning process. Successful coordination of C-XRT occurred when electronic notification of task completion was within 24 hours of the initiation of radiation. <h3>Results</h3> From 11/26/2019 to 12/14/2021 a total of 411 orders for chemo-coordination were placed. The success rate for all orders was 94% (386 patients). The physician order date on 5 orders to coordinate came after the start of radiation. Removing these orders to coordinate improved the total successful coordination rate to 95%. Six percent (25 patients) chemo was coordinated after the initiation of treatment. Range of failures were 2-44 days after the start of therapy. For patients with highest days of failure, days 23, 35, and 44, all had orders to coordinate after the start of radiation. Only 2% of patients had coordinated chemo 7 days after the initiation of radiation. Eight percent of patients had completed coordination within first 24 hours after the initiation of radiation. The disease site breakdown for requests were as follows: Bone (12), Breast (9), CNS (65), HN (98), Lung (35), GU (13), GI (90), Heme (2), Unspecified (1). Coordination effort success rates were as follows: Bone (83%), Breast (89%), CNS (92%), HN (97%), Lung (94%), GU (100%), GI (85%), Heme (50%). <h3>Conclusion</h3> We successfully demonstrated that when correctly implemented, a C-XRT coordination process with regular team huddles can result in 95% successfully coordinated C-XRT. We are now working to improve the timeliness of coordinate C-XRT physician orders.

Efficient 3D measurement of a HDR surface basedon adaptive fringe projection.

3D measurement methods of a high-dynamic-range (HDR) surface based on adaptive fringe projection have aroused extensive research interest. They tend to pixel-wise adjust the fringe projection intensity to ensure full-field phase quality in light or dark regions, which has two problems: (1)traditional image intensity-based temporal phase unwrapping (TPU) is susceptible to noise in dark regions, and (2)it is time-consuming to project orthogonal fringe patterns for coordinate mapping and 3D reconstruction. Aiming to address these issues, we present an efficient adaptive fringe projection method where misaligned Gray code patterns are adopted to remove the phase error induced by low-frequency fringe patterns. Compared with traditional image intensity-based TPU, misaligned Gray-code-based TPU provides a better noise-suppression effect in dark regions, as Gray codes are generally better preserved than image intensity. Moreover, the images captured in the coordinate mapping process are shared for optimal projection intensity calculation and 3D reconstruction to reduce the number of total projection patterns, thus improving measurement efficiency. Extensive contrast experiments are conducted to demonstrate that the proposed method retrieves the 3D shapes of micro-scale HDR surfaces with high accuracy and a minimum number of projection patterns on the premise of high measurement integrity.

Первый опыт двусторонних консультаций для Госплана Монголии в рамках Совета экономической взаимопомощи (сентябрь–октябрь 1963 г.)

Introduction. Since Mongolia joined the Council for Mutual Economic Assistance it became obliged to coordinate its planning activities with other member countries. And the planning coordination process proper essentially included arrangements of bilateral consultations between Mongolia’s planning agency and those of corresponding member countries. Goals. So, the study aims at examining earliest bilateral consultations held by Mongolia’s Planning Commission in September–October of 1963. Materials and methods. The article analyzes documents from the Russian State Archive of Contemporary History and the Russian State Archive of the Economy. The key research methods employed are the comparative historical and typological ones. Results. The mentioned bilateral consultations were discussing two groups of questions, namely: a list of enterprises the Mongolian party was going to construct with the aid of other CMEA member countries, and lists of goods to be exchanged between the involved countries through the balance method. Conclusions. The bilateral consultations between the MPR’s Planning Commission and planning agencies of CMEA member governments held in September–October of 1963 proved an absolutely new line of activity for Mongolian economists. The former’s key points were discussions over lists of construction and other facilities required by the Mongolian party. And the almost full absence of data pertaining to construction funding sources implies the negotiation process — at that very stage — was far from being complete. It was the Soviet Union that was still expected to invest most in Mongolia’s economy and bear the bulk of responsibility for the to be constructed enterprises. The ‘greediest’ government engaged in discussions over economic aid to Mongolia was that of Romania, other CMEA member countries to have clustered into a group of so called ‘averages’. The latter did not differ much in scales of to be rendered aid, while essentials of their sector-specific investments did vary to some extent.

SIMCard: Toward better connected electronic health record visualization

SummaryRecently, several healthcare organizations use decision‐making systems based on electronic health record (EHR) data in order to guarantee patient's safety and improve the quality of healthcare. In essence, the evolutions of Internet of Things (IoT) technologies have been of great help for implementing an integrated and interoperable decision‐making system based on EHR and medical devices (MDs). Those IoT‐based systems allow Clinicians collecting real‐time health data and provide accurate patient's monitoring. Nevertheless, several studies have shown that it is hard to improve the quality of healthcare using the current EHR IoT‐based systems since they do not allow to easily express clinician needs. Interactive visualization tools have been proposed to improve the efficacy and utility of these EHR based systems. However, there is no framework that provides a visual summary of patient data to clinician for planning specific clinical tasks, subsequently evaluating clinician responses, visually exploring EHR data and MDs data, gaining insights, supporting dynamic coordination processes care, and forming and validating hypotheses and risks. This article addresses this problem and introduces SIMCard, an aggregation‐based connected EHR visualization framework for patient monitoring, interpreting and predicting with MDs. The proposed framework aims to synthesize patient's clinical data into a single aggregating model for both EHR and MD conforming to health standard and terminologies. It also allows to link the aggregating model to the relevant medical knowledge in order to provide a connected and dynamic care and preventive plan. Last but not least, it provides an aggregated visualization model capable of displaying graphically a patient's personal data from databases, healthcare devices and sensors to reduce cognitive barriers related to the complexity of medical information and interpretation of health data. To demonstrate the refinement and design of our system and to observe user's actual practice of visualizing and analyzing real‐world dataset, we evaluated our system and compare to existing ones.

Developing and validating a comprehensive measure of coordination in patient aligned care teams

Background/ObjectiveDespite numerous extant measures assessing context-specific elements of care coordination, we are unaware of any comprehensive, team-based instrument that measures the requisite mechanisms and conditions required to coordinate successfully. In this study we develop and validate the psychometric properties of the Coordination Practices Survey, a context-agnostic measure of coordination for primary care teams.MethodsCoordination items were developed based on a systematic literature review; items from previously developed scales were adapted and new items were created as needed; all items were refined after subject matter expert review and feedback. We collected data from Primary Care teams drawn from 1200 Veterans Health Administration (VHA) medical centers and outpatient clinics nationwide. 1645 primary care team members from 512 patient aligned care teams in the Veterans Health Administration completed the survey from 2015 to 2016. Psychometric properties were assessed after data collection using Cronbach’s alpha, intraclass correlations and multilevel confirmatory factor analysis to assess the factor structure.ResultsOur findings confirmed the psychometric properties of two distinguishable subscales of coordination: (a) Accountability and (b) Common Understanding. The within- and between-team latent structure of each subscale exhibited adequate fit to the data, as well as appropriately high Cronbach’s alpha and intraclass correlations. There was insufficient variability in responses to the predictability subscale to properly assess its psychometric properties.ConclusionWith context-specific validation, our subscales of accountability and common understanding may be used to assess coordination processes in other contexts for both research and operational applications.