Building a Rehabilitative Care Measurement Instrument to Improve the Patient Experience

Publication date: January 2019

Source: Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 1

Author(s): Josephine McMurray, Heather McNeil, Alicia Gordon, Jacobi Elliott, Paul Stolee

Abstract

Objective

To develop and test face and content validity, and user interface design of a rehabilitative care patient experience measure.

Design

Mixed methods, cross-sectional validation study that included subject matter expert input. Cognitive interviewing tested user interface and design.

Setting

Outpatient rehabilitative care settings.

Participants

Subject matter experts (n=3), health care providers (n=137), and patients and caregivers (n=5) contributed to the question development. Convenience and snowball sampling were used to recruit rehabilitative care patients postdischarge (n=9) for cognitive interviews to optimize survey design and user interface (N=154).

Interventions

Not applicable.

Main Outcome Measure

This novel survey instrument measures 6 concepts previously identified as key to outpatient rehabilitative care patients’ experience: ecosystem issues, client and informal caregiver engagement, patient and health care provider relations, pain and functional status, group and individual identity, and open-ended feedback.

Results

502 survey questions from psychometrically tested instruments, secondary data from a related ethnographic study, and consultations with health care providers, patients, caregivers, and subject matter experts, were analyzed to create a 10-item questionnaire representing 6 key constructs that influence patient experience quality. Cognitive interviewing with 9 patients (3 rounds of 3 participants each), produced 3 progressively edited versions of the survey instrument. A final version required no further modifications.

Discussion

Rehabilitative care clients have characteristics that differentiate their experience from that of other sectors and patient groups, warranting a distinct experience measure. The survey instrument includes a parsimonious set of questions that address strategic issues in the ongoing improvement of care delivery and the patient experience in the rehabilitative care sector.

Conclusion

The rehabilitative care patient experience survey instrument developed has an acceptable user interface, and content and face validity. Psychometric testing of the survey instrument is reported elsewhere.

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