title: Measuring primary care organizational capacity for diabetes care coordination: the Diabetes Care Coordination Readiness Assessment.
abstract: BACKGROUND
  Not all primary care clinics are prepared to implement care coordination services for chronic conditions, such as diabetes. Understanding true capacity to coordinate care is an important first-step toward establishing effective and efficient care coordination. Yet, we could identify no diabetes-specific instruments to systematically assess readiness and/or status of primary care clinics to engage in diabetes care coordination.
  
  
  OBJECTIVE
  This report describes the development and initial validation of the Diabetes Care Coordination Readiness Assessment (DCCRA), which is intended to measure primary care clinic readiness to coordinate care for adult patients with diabetes.
  
  
  METHODS
  The instrument was developed through iterative item generation within a framework of five domains of care coordination: Organizational Capacity, Care Coordination, Clinical Management, Quality Improvement, and Technical Infrastructure.
  
  
  METHODS
  Validation data was collected on 39 primary care clinics.
  
  
  METHODS
  Content validity, inter-rater reliability, internal consistency, and construct validity of the 49-item instrument were assessed.
  
  
  RESULTS
  Inter-rater agreement indices per item ranged from 0.50 to 1.0. Cronbach's alpha of the entire instrument was 0.964, and for the five domain scales ranged from 0.688 to 0.961. Clinics with existing care coordinators were rated as more ready to support care coordination than clinics without care coordinators for the entire DCCRA and for each domain, supporting construct validity.
  
  
  CONCLUSIONS
  As providers increasingly attempt to adopt patient-centered approaches, introduction of the DCCRA is timely and appropriate for assisting clinics with identifying gaps in provision of care coordination services. The DCCRA's strengths include promising psychometric properties. A valid measure of diabetes care coordination readiness should be useful in diabetes program evaluation, assistance with quality improvement initiatives, and measurement of patient-centered care in research.
authors.affiliation: Inland Northwest Health Services, 601 W. First Ave., Spokane, WA, 99201, USA, weeksdl@inhs.org.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Weeks
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Polello
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Hansen
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Keeney
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Conrad
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001291:Attitude of Health Personnel; D057191:Capacity Building / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation / Q000379:methods; D011594:Psychometrics; D015203:Reproducibility of Results; D014481:United States
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