A Systematic Review of the Consumer Emergency Care Satisfaction Scale (CECSS)

Abstract

Background: Patient experience is receiving increasing attention in the context of patient-centered care. However, there are relatively few instruments that measure patient experience that are valid and reliable. Objective: In this study, we systematically review the literature on the Consumer Emergency Care Satisfaction Scale (CECSS) and examine its psychometric properties. Methods: We conducted a systematic literature search in the Cumulative Index to Nursing and Allied Health Literature, PubMed, PsycINFO, and Web of Science databases on articles that contain information on the CECSS. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Our systematic literature search resulted in 28 articles in which the CECSS was used. Conclusions: Results of our literature review show that from a psychometric perspective, the CECSS is a valid and reliable instrument. However, the results of our study also show that the CECSS has several weaknesses. We have made recommendations to improve the CECSS.

Satisfaction of Older Patients With Emergency Department Care

“…10 However, in most studies, the items are recoded so that a higher score means a better patient experience. 14 In the original publication and most publications that followed, scores were calculated only for cases without missing values. 10 In general, 3 scores are calculated: a full CECSS score to measure overall patient ED experience based on the 15 positively worded items, with scores ranging from 15 to 75; a Caring subscale score based on 12 positively worded items, with scores ranging from 12 to 60; and a Discharge Teaching subscale score based on 3 positively worded items, ranging from 3 to 15.…”

“…However, it also shows that the CECSS has limitations and can be improved. 14 There are several issues with the CECSS and most of them have been addressed in this study. First, a large proportion of ED patients (41% in our study) are not discharged from the ED but admitted to the hospital and therefore do not receive discharge instructions.…”

“…The CECSS contained 19 items. 10,14,23 We made several changes to the CECSS. To better measure the overall patient ED experience and not only satisfaction with nursing, we replaced the word "nurse" in the questionnaire with "health care worker(s)" (eg, "The health care worker was skillful in performing her/his duties").…”

“…14 However, there are several issues with the current version of the CECSS. 14 First, the CECSS does not apply to all patients in the ED, only to those patients who are discharged home. It does not apply, for example, to patients who are admitted to the hospital.…”

“…Ceiling effects can cause several problems. 14 First, it is impossible to increase a perfect score. Second, if many respondents select the highest score, it is not feasible to use correlation and regression analysis to examine relationships with other key variables.…”