Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT)

Abstract

ObjectiveTo develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT.BackgroundMeasuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used.MethodsCEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility.ResultsCVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28–0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact.ConclusionsCEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.

Using Content Validity for the Development of Objective Structured Clinical Examination Checklists in a Slovenian Undergraduate Nursing Program

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Improving wait time from referral to opiate replacement therapy in a drug recovery service

“…CEFIT is a brief survey tool, which has good structural validity and internal reliability (Cronbach’s alpha 0.78) making it an appropriate tool for repeated quality improvement measurement. 18 The maximum score attainable with CEFIT is 25, and this is also the target score, as it is designed with the ambition of high quality of care for every patient, every time. The CEFIT was completed by clients in treatment during phase I and at subsequent data collection points.…”