Continuity Index Measures in the Acute Care Hospital Setting: An Analytic Review and Tests Using Electronic Health Record Data and Computer Simulation.

BACKGROUND AND
PURPOSE: Multiple continuity indexes are available; however, their properties are insufficiently understood for examining the influence of nurse staffing patterns on patient outcomes. We conceptually and analytically examined continuity measures to reveal their properties and relationships with each other and identify potential limitations.
METHODS: We examined behavior of continuity indexes as applied to clinical practice data that were collected with the HANDS (Hands-On Automated Nursing Data System) and data from computer simulation.
RESULTS: Studied continuity measures exhibited very different statistical characteristics. Most importantly, many continuity measures contain a length-of-stay dependent term that is uncorrelated with continuity.
CONCLUSION: Findings provide a deep understanding of the conceptual foundations and properties of various continuity measures. Using findings, researchers can select proper measures and better interpret analysis outcomes.