The Care Process Self-Evaluation Tool: a valid and reliable instrument for measuring care process organization of health care teams

BACKGROUND: Patient safety can be increased by improving the organization of care. A tool that evaluates the actual organization of care, as perceived by multidisciplinary teams, is the Care Process Self-Evaluation Tool (CPSET). CPSET was developed in 2007 and includes 29 items in five subscales: (a) patient-focused organization, (b) coordination of the care process, (c) collaboration with primary care, (d) communication with patients and family, and (e) follow-up of the care process. The goal of the present study was to further evaluate the psychometric properties of the CPSET at the team and hospital levels and to compile a cutoff score table. METHODS: The psychometric properties of the CPSET were assessed in a multicenter study in Belgium and the Netherlands. In total, 3139 team members from 114 hospitals participated. Psychometric properties were evaluated by using confirmatory factor analysis (CFA), Cronbach’s alpha, interclass correlation coefficients (ICCs), Kruskall-Wallis test, and Mann–Whitney test. For the cutoff score table, percentiles were used. Demographic variables were also evaluated. RESULTS: CFA showed a good model fit: a normed fit index of 0.93, a comparative fit index of 0.94, an adjusted goodness-of-fit index of 0.87, and a root mean square error of approximation of 0.06. Cronbach’s alpha values were between 0.869 and 0.950. The team-level ICCs varied between 0.127 and 0.232 and were higher than those at the hospital level (0.071-0.151). Male team members scored significantly higher than females on 2 of the 5 subscales and on the overall CPSET. There were also significant differences among age groups. Medical doctors scored significantly higher on 4 of the 5 subscales and on the overall CPSET. Coordinators of care processes scored significantly lower on 2 of the 5 subscales and on the overall CPSET. Cutoff scores for all subscales and the overall CPSET were calculated. CONCLUSIONS: The CPSET is a valid and reliable instrument for health care teams to measure the extent care processes are organized. The cutoff table permits teams to compare how they perceive the organization of their care process relative to other teams

A rules of thumb-based design sequence for diffuse daylight

This paper proposes and validates a daylighting design sequence for sidelit spaces. Since the design sequence uses the daylight factor as a performance metric, it is aimed towards spaces that primarily receive diffuse daylight. It should be complemented by a design analysis that looks at direct sunlight for glare and energy considerations. The sequence interconnects and refines earlier proposed rules of thumb and is intended to be used during the earliest design stages when concepts regarding programming, floor plans, massing and window areas are initially explored. All steps within the sequence were ‘validated' using Radiance simulations of over 2300 sidelit spaces. During step one of the sequence the effective sky angles are calculated and target daylight factors are defined for all potential daylit zones within a building. In step two a refined version of the ‘daylight feasibility study' is used to help the design team to identify building zones with high daylighting potential based on a target mean daylight factor criterion. During step three suitable interior room dimensions and surface reflectances are determined using a combination of the Lynes' limiting depth, ‘no sky line', and window-head-height rules of thumb. Step four provides a more accurate estimate of the required glazing area for each zone based on the Lynes daylight factor formula which is also validated as part of this work. The effect of external obstructions is considered throughout the process. The paper closes with a discussion of the merits of the design sequence compared to the glazing factor spreadsheet calculation method promoted by LEED-NC 2.2