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Assessment of the measurement properties of the NHCAHPS family survey a Rasch scaling approach


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Assessment of the measurement properties of the NHCAHPS family survey a Rasch scaling approach
Table of Contents
Abstract
Acknowledgements
Table of Contents
List of Tables
List of Figures
List of Abbreviations
List of Symbols
I. Introduction
A. Five-Star Quality Rating System
B. Consumer Assessment of Healthcare Providers and Systems (CAHPS)
a. NHCAHPS Family Survey Scoring and Reporting
C. Impact of Satisfaction Measurement
a. Financial Implications
b. Process Improvement
D. Instrument Development
E. Statement of the Problem
F. Purpose
G. Research Questions
II. The Current Methods for Collecting and Applying Quality Data in Skilled Skilled Nursing Facilities
A. Groups Advancing SNF Quality
B. Current View of Quality in Skilled Nursing Facilities
a. Annual Survey Inspection
b. Complaint Survey Investigations
c. Nursing Home Compare
d. Health Inspection Domain
e. Staffing Domain
f. Quality Measure Domain
g. Overall SNF rating (Composite Measure)
C. Issues with Current Quality Indicators
a. Parsimony
b. Measurement Issues
c. Consumer-Determined Quality
D. The Rasch Model
E. Outcomes of Quality Indicators
a. Pay for Performance
b. Accountable Care Organizations
III. Methods and Procedures
A. Research Participants
B. Instrumentation
C. Data Management and Collection
a. Phase 1: Facility Notification of the Survey
b. Phase 2: Assignment of survey recipient
c. Phase 3: Survey Notification and Distribution
D. Theoretical Framework for Measure Construction
a. Rating Scale Rasch Model
E. Data Analysis
a. Reliability
b. Validity
IV. Results
A. Diagnostic Analyses
a. Reliability Analyses
b. Scale Category Analyses
i. Rating scale type 1
ii. Rating scale type 2
iii. Rating scale type 3
iv. Rating scale type 4
v. Rating scale type 5
B. Improving the Rating Scales
a. Collapsing Recommendation to Others Scale
b. Overall Rating of Care
C. Diagnostic Analysis with Random Samples
a. Scale Category Analysis
D. Item Fit Analyses
E. Variable Meaning
F. Principle Contrasts Analysis
G. Composite Domain Analysis
a. Meeting Basic Needs Composite Domain
b. Nurses and Aides Kindness and Respect Towards Resident
c. Nursing Home Provides Information and Encourages Respondent Involvement
d. Nursing Home Staffing, Care of Belongings and Cleanliness
V. Discussion
A. Summary of Rasch Findings
B. Application of Findings
C. Improvement Recommendations
a. General Changes
b. Overall Rating of Care
D. Limitations
References
Appendices
A. NHCAHPS Family Survey
B. Composite Measure Proportional Scoring Method Description and Example
C. Composite Measures for the NHCAHPS Family Member Survey
D. Detailed Description of Scale Collapsing for Overall Quality of Care Item 
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