Development of a scientifically valid coordinated care path.

Abstract

OBJECTIVE: The goal of this study was to develop a method to scientifically create and validate a coordinated care path for use within any hospital setting. BACKGROUND: In an attempt to reduce the costs associated with high-volume and high-risk diagnosis, attention was focused on reducing patients' length of stay in the hospital. A method to reduce length of stay uses a coordinated care path. A path is a guideline used to manage the clinical care of selected patients. The literature is relatively silent regarding studies that have scientifically validated the use of these paths. METHODS: This project used a content validity method to validate the care path. Using current research findings, best practice standards both locally and nationally, a transdisciplinary team developed practice guidelines that included sequencing, timing of interventions, and expected patient outcomes. The path was rated by local and national experts using a four-point rating scale. Using Lynn's proportion of experts table computations, the validity of the path and each of its components was determined. RESULTS: Of 161 items on the care path, 10 were not validated. The experts validated the instrument as a whole. Of the 161 items, 151 were validated. This is an instrument validation rate of 0.94. No additional changes or modifications to the path were suggested by the experts. The transdisciplinary team addressed the nonvalidated items. This method can be used to develop other coordinated paths for other diagnostic groups.