Closing the patient experience chasm: A two‐level validation of the Consumer Quality Index Inpatient Hospital Care

Smirnova, Alina; Lombarts, Kiki M. J. M. H.; Arah, Onyebuchi A.; Vleuten, Cees van der

doi:10.1111/hex.12545

Cited by 13 publications

(30 citation statements)

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“…A limitation of this study is the low response rate. Non-response is a common challenge in research on patient experiences 24 48. Possible reasons for the low response rate may relate to sex comorbidity, and age.…”

Section: Discussionmentioning

confidence: 99%

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

et al. 2019

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BackgroundDischarge conversation is an essential part of preparing patients for the period after hospitalisation. Successful communication during such conversations is associated with improved health outcomes for patients.ObjectiveTo investigate the association between discharge conversation and discharge quality assessed by measuring elderly patients’ experiences.MethodsIn this cross-sectional study, we surveyed all patients ≥65 years who had been discharged from two medical units in two hospitals in Western Norway 30 days prior. We measured patient experiences using two previously validated instruments: The Discharge Care Experiences Survey Modified (DICARES-M) and The Nordic Patient Experiences Questionnaire (NORPEQ). We examined differences in characteristics between patients who reported having a discharge conversation with those who did not, and used regression analyses to examine the associations of the DICARES-M and NORPEQ with the usefulness of discharge conversation.ResultsOf the 1418 invited patients, 487 (34%) returned the survey. Their mean age was 78.5 years (SD=8.3) and 52% were women. The total sample mean scores for the DICARES-M and NORPEQ were 3.9 (SD=0.7, range: 1.5–5.0) and 4.0 (SD=0.7, range: 2.2–5.0), respectively. Higher DICARES-M and NORPEQ scores were found for patients who reported having a discharge conversation (74%) compared with those who did not (15%), or were unsure (11%) whether they had a conversation (p<0.001). Patients who considered the conversation more useful had significantly higher scores on both the DICARES-M and NORPEQ (p<0.001).ConclusionsReported discharge conversation at the hospital was correlated with positive patient experiences measurements indicating the increased quality of hospital discharge care. The reported usefulness of the conversation had a significant association with discharge care quality.

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Section: Discussionmentioning

confidence: 99%

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

et al. 2019

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“…Mode of administration of the HCAHPS was by mail, telephone, and interactive voice recognition, where data were collected between 48 hours to six weeks, and the instrument got a four- point Likert like scale. The Consumer Quality Index (CQI) questionnaire is based on the HCAHPS and was used by Smirnova et al [ 41 ] in a study from 2017 that included almost 23,000 patients and where nearly half of the respondents were 65 years or older. The results showed that variations in the measurement of patient experiences could be attributed to variation in quality of care.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that variations in the measurement of patient experiences could be attributed to variation in quality of care. Five items in the DICARES cover communication between the patients and the health care personnel, who has emerged as more important than previously thought [ 41 ]. The total mean score of the DICARES was 4.04, and somewhat higher than the score on the subscale Information at discharge according to the study of Smirnova et al [ 41 ] with mean score 0.7, corresponding to 77% and 70% of maximum scores, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Five items in the DICARES cover communication between the patients and the health care personnel, who has emerged as more important than previously thought [ 41 ]. The total mean score of the DICARES was 4.04, and somewhat higher than the score on the subscale Information at discharge according to the study of Smirnova et al [ 41 ] with mean score 0.7, corresponding to 77% and 70% of maximum scores, respectively. Even if the results in the study of Smirnova et al may be hampered by relatively low response rate and by methodological issues discussed by Felix et al [ 22 ], we found this comprehensive study appropriate to compare with the DICARES, attributable to the large group of eldery patiets included in the study.…”

Section: Discussionmentioning

confidence: 99%

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Elderly patients’ (≥65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey

et al. 2018

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BackgroundA review of the literature reveals a lack of validated instruments that particularly measure quality in the hospital discharge process. This study aims to develop and validate a survey instrument feasible for measuring quality (≥65 years) related to the discharge process based on elderly patients’ experiences.MethodsConstruction of the Discharge Care Patient Experience Survey (DICARES) was based on 16 items identified by literature reviews. Intraclass correlation for test–retest was applied to assess consistency of the survey. Explorative factors analysis was applied to identify and validate the factor structures of the DICARES. Cronbach’s α was used to assess internal reliability. To evaluate the external validity of the final DICARES questionnaire the patients’ scores were correlated with scores obtained from the three other questionnaires; the Nordic Patient Experiences Questionnaire, the 12-Item Short-Form Health Survey and Subjective Health Complaints. The DICARES association with readmissions was examined.ResultsA total of 270 patients responded (64.4%). The mean age of participants was 77.1 years and 57.8% were men. The exploratory factor analysis resulted in a 10-item instrument consisting of three factors explaining 63.5% of the total variance. The Cronbach’s α were satisfactory (≥70). Overall intraclass correlation was 0.76. A moderate Spearman correlation (rho = 0.54, p <0.01) was found between the total mean DICARES score and total mean score of the Nordic Patient Experiences Questionnaire. The total mean DICARES score was inversely associated with the quality indicator based on readmissions (OR 0.62, CI 95: 0.41–0.95, p = 0.028)ConclusionWe have developed a 10-item questionnaire consisting of three factors which may be a feasible instrument for measuring quality of the discharge process in elderly patients. Further testing in a wider population should be carried out before implementation in health care settings.

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“…Index. 23 Following instrument development and pilot testing, this parent-reported outcome will be administered via electronic tablet to parents/guardians between six and seventy-two hours following hospital admission.…”

Section: Intervention Core Elementsmentioning

confidence: 99%

Comparative Effectiveness of Direct Admission & Admission through Emergency Departments for Children: A Randomized Stepped Wedge Study Protocol

Leyenaar

McDaniel

Acquilano

et al. 2020

Preprint

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Background: Approximately 2 million children are hospitalized each year in the United States, with more than three-quarters of non-elective hospitalizations admitted through emergency departments (EDs). Direct admission, defined as admission to hospital without first receiving care in the hospital’s ED, may offer benefits for patients and healthcare systems in quality, timeliness, and experience of care. While ED utilization patterns are well studied, there is a paucity of research comparing the effectiveness of direct and ED admissions. The overall aim of this project is to compare the effectiveness of a standardized direct admission approach to admission beginning in the ED for hospitalized children.Methods/Design: We will conduct a stepped wedge cluster randomized controlled trial at 3 structurally and geographically diverse hospitals. A total of 70 primary and urgent care practice sites in the hospitals’ catchment areas will be randomized to a time point when they will begin participation in the multi-stakeholder informed direct admission program. This crossover will be unidirectional and occur at 4 time points, six months apart, over a 24-month implementation period. Our primary outcome will be the timeliness of clinical care provision. Secondary outcomes include: (i) parent-reported experience of care; (ii) unanticipated transfer to the intensive care unit within 6 hours of hospital admission; and (iii) rapid response calls within 6 hours of hospital admission. We anticipate that 190 children and adolescents will be directly admitted, with 1506 admitted through EDs. Analyses will compare the effectiveness of direct admission to admission through the ED, and will evaluate the causal effect of implementing a direct admission program using linear regression with random effects for referring practice clusters and time period fixed effects. We will further examine heterogeneity of treatment effects based on hypotheses specified a priori. In addition, we will conduct a mixed-methods process evaluation to assess reach, effectiveness, adoption, implementation and maintenance of our direct admission intervention.Discussion: Our study represents the first randomized controlled trial to compare the effectiveness of direct admission to admission through the ED for pediatric patients. Our scientific approach, pairing a stepped-wedge design with a multi-level assessment of barriers to and facilitators of implementation, will generate valuable data about how positive findings can be reproduced across other healthcare systems.Trial registration: This trial is registered in ClinicalTrials.gov (NCT04192799, registered December 10, 2019, https://clinicaltrials.gov/ct2/show/NCT04192799)

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Closing the patient experience chasm: A two‐level validation of the Consumer Quality Index Inpatient Hospital Care

Cited by 13 publications

References 31 publications

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

Elderly patients’ (≥65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey

Comparative Effectiveness of Direct Admission & Admission through Emergency Departments for Children: A Randomized Stepped Wedge Study Protocol

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Closing the patient experience chasm: A two‐level validation of the Consumer Quality Index Inpatient Hospital Care

Cited by 13 publications

References 31 publications

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

Measuring discharge quality based on elderly patients’ experiences with discharge conversation: a cross-sectional study

Elderly patients’ (≥65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey

Comparative Effectiveness of Direct Admission &amp; Admission through Emergency Departments for Children: A Randomized Stepped Wedge Study Protocol

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Product

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Comparative Effectiveness of Direct Admission & Admission through Emergency Departments for Children: A Randomized Stepped Wedge Study Protocol