Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Zainab Dedat; Steven Hope; Dougal Hargreaves; Oliver Lloyd-Houldey; Dasha Nicholls; Steph Scott; Evgenia Stepanova; Carolyn Summerbell; Russell M. Viner; Frances Hillier-Brown

doi:10.5334/ijic.7028

Figures & Tables

PRISMA diagram of the study selection process for instruments measuring integration within children and young people healthcare systems.

Table 1

Descriptions of instruments (n = 16) measuring integration within children and young people healthcare systems by outcomes measured.

MEASUREMENT INSTRUMENTS	TYPE OF MEASUREMENT INSTRUMENT	DESCRIPTION OF MEASUREMENT INSTRUMENTS
*Outcome: Quality of care coordination*
Primary Care Assessment Tool (PCATool Brazil) [36]*† (Also measures Completeness of care and Structure of care)	Questionnaire (completed by HCPs)	55-item Likert-scale instrument Assesses the structure and process of the system by measuring longitudinally, accessibility, coordination, system information, integrality of care and other factors
Bice-Boxerman Continuity of Care index (indicator of quality of CC) [24]	Simple administration method (from visit records)	Measures the concentration of visits with a core set of providers, yielding an assessment of team-based continuity
Caregiver’s survey [25]*	Questionnaire (completed by caregivers)	Questions taken from Medical Home Family Index (MHI), and the Client Perception of Coordination Questionnaire (CPCQ) Measures quality of life, satisfaction, care coordination and self-efficacy.
Care-coordination Measurement Tool (CCMT) [23]	Simple administration method (from visit records)	Records all non-reimbursable care coordination activity encounters performed by office-based personnel
Family Experiences of Coordination of Care (FECC) [26 28]	Questionnaire (completed by caregivers)	20 quality measures Questions in three main areas (care coordination services, messaging, and protocols/plans)
Framework for evaluating patient care communication [31]*† (Also measures Quality of communication)	Three stage process: 1) Questionnaire (completed by caregivers), 2) Interviews (with caregivers) and 3) Focus Groups (with HCPs)	Three-step mixed designs evaluation approach: 1) Patient quality questionnaire communication links with quality gaps (Primary Care Assessment Survey or the Measure of Processes of Care); 2) In-depth interviews with subset of patients underlying factors of quality gaps; 3) Focus group meetings with involved professionals additional related factors.
The Paediatric Integrated Care Survey (PICS) [30]† (Also measures Completeness of care)	Questionnaire (completed by caregivers)	19 experience items across 5 scales: access, communication, family impact, care goal creation and team functioning
*Outcome: Quality of collaboration*
Collaborative Care for Attention-Deficit Disorders Scale (CCADDS) [27]	Questionnaire (completed by HCPs)	41-item instrument Measures the collaborative care processes for children with attention-deficit/hyperactivity disorder who attend primary care practices
Perception of Interprofessional Collaboration Model Questionnaire (PINCOM-Q) [34]	Questionnaire (completed by HCPs)	48-item instrument Measures perceptions of the inter-professional collaboration process on an individual, group and organisational level and includes subscales such as motivation, culture, communication, organisational aims and group leadership
Echelle De Confort Decisionnel-Partnenaire (ECD-P) [34]	Questionnaire (completed by HCPs)	Adapted version of a shared decision-making scale Focuses on the appraisal of specific clinical interactions and documenting perceptions about collaborations involving clinical events
Journey Tool [33]	Four stage process (conducted by child services evaluators)	Four phases: 1) patient case file evaluation; 2) interviews with child and caregivers about their situation and experience with the services offered; 3) meeting with associated HCPs.
Interprofessional collaboration competency scale [37]	Questionnaire (completed by health, medical, welfare and education professionals)	30-item instrument Four preliminary domains: sharing information, understanding, function, coordinating support objectives and securing
The Human Services Integration Measure Scale (HSIM) [35]	Questionnaire (completed by health, educational, social, justice, recreational, and cultural sector professionals)	5-point ordinal scale to rate both current and expected level of involvement with the other agencies within the network. Scale used to validate an integration framework which is based on awareness, communication, collaboration and cooperation
*Outcome: Continuity of care*
Continuity of Care in Children’s Mental Health-Parent (C3MH-P) [29]	Questionnaire (completed by caregivers)	Scale based on three types of continuity: management (collaboration/transitions/flexibility), informational (information exchange/provider knowledge), and relational (interpersonal/consistency over time and transitions)
Continuity of Care in Children’s Mental Health-Youth (C3MH-Y) [29]	Questionnaire (completed by CYP)	Scale based on three types of continuity: management (collaboration/transitions/flexibility), informational (information exchange/provider knowledge), and relational (interpersonal/consistency over time and transitions)
*Outcome: Completeness of care*
Primary Care Assessment Tool (PCATool Brazil) [36]*† (Also measures Quality of care coordination and Structure of care)	Questionnaire (completed by HCPs)	55-item Likert-scale instrument Assesses the structure and process of the system by measuring longitudinally, accessibility, coordination, system information, integrality of care and other factors
The Paediatric Integrated Care Survey (PICS) [30]† (Also measures Quality of care coordination)	Questionnaire (completed by caregivers)	19 experience items across 5 scales: access, communication, family impact, care goal creation and team functioning
*Outcome: Structure of care*
Primary Care Assessment Instrument (PCAInstrument Brazil) [36]*† (Also measures Quality of care coordination and Completeness of care)	Questionnaire (completed by HCPs)	55-item Likert-scale instrument Assesses the structure and process of the system by measuring longitudinally, accessibility, coordination, system information, integrality of care and other factors
*Outcome: Quality of communication*
Framework for evaluating patient care communication [31]*† (Also measures Quality of care coordination)	Three stage process: 1) Questionnaire (completed by caregivers), 2) Interviews (with caregivers) and 3) Focus Groups (with HCPs)	1) Patient quality questionnaire communication links with quality gaps (Primary Care Assessment Survey or the Measure of Processes of Care); 2) In-depth interviews with subset of patients underlying factors of quality gaps; 3) Focus group meetings with involved professionals additional related factors.
*Outcome: Local implementation of integrated care*
Instrument to monitor the local implementation of Integrated Care for Childhood Overweight and obesity (TICCO) [32]	Questionnaire (completed by HCPs involved in project organisation)	47-item instrument Assesses eight domains: Commitment, Inter-professional teamwork, Client centeredness, Delivery system, Quality of support and care, Result-focused learning, Monitoring, and Organization and financing

[i] *Study describes development of the measurement instrument only (not evaluated for feasibility, reliability or validity); †instrument measures more than one outcome.

Table 2

Summary of evaluation results of instruments (n = 13) measuring integration within children and young people healthcare systems.

MEASUREMENT INSTRUMENT	FEASIBILITY	RELIABILITY	VALIDITY
MEASUREMENT INSTRUMENT	FEASIBILITY	RELIABILITY	CONTENT	CONSTRUCT	CRITERION
Care-coordination Measurement Tool (CCMT)[23]*	✓
Bice-Boxerman Continuity of Care [24]*				✓
Family Experiences with Coordination of Care (FECC) [26 28]	✓			✓
Collaborative Care for Attention-Deficit Disorders Scale (CCADDS)[27]		✓		✗
Instrument to monitor the local implementation of Integrated Care for Childhood Overweight and obesity (TICCO) [32]	✓		✓
Perception of Interprofessional Collaboration Model Questionnaire (PINCOM-Q) [34]	✓	✓
Echelle de confort decisionnel-partenaire (ECD-P) [34]	✓	✓
Journey Tool [33]			✗
Interprofessional collaboration competency scale [37]*		✓		✓
Continuity of Care in Children’s Mental Health-Parent (C3MH-P) [29]*		✓	✓	✓	✓
Continuity of Care in Children’s Mental Health-Youth (C3MH-Y) [29]*		✓	✓	✓	✓
The Human Services Integration Measure Scale (HSIM)[35]*		✓
The Paediatric Integrated Care Survey (PICS) [30]*		✓		✓

[i] ✓ = reasonable feasibility (quality of methods not assessed); ✓ = reasonable reliability or validity (methods very good); ✓ = reasonable reliability or validity (methods doubtful or inadequate); ✗ = inadequate validity (methods very good); ✗ = inadequate validity (methods doubtful or inadequate).

* Highlighted by authors as promising instruments based on of administration method and measurement properties, with consideration of the type of system that the instrument was designed for and evaluated in. Wider contextual factors may be considered when selecting instruments to be used in research and practice.

Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Figures & Tables

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Table 1

Table 2

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