User reported experiences and satisfaction are increasingly used as basis for quality indicators in the health sector. However, there is limited understanding of factors associated with user reported experiences and satisfaction with casualty clinics.
A random sample of 542 patients that had contacted any of three casualty clinics from mid April to mid May 2008 was mailed a questionnaire. A reminder was sent to non-respondents after six weeks. Descriptive statistics for four user reported experiences scales and 20 single items are presented. Multivariate regression analysis was used to assess associations between background variables and user reported experiences, and between user reported experiences and user satisfaction.
225 (41.5%) patients, carers and guardians returned a completed questionnaire. Users reported most positive experiences with the doctor services and the nursing services at the casualty clinics; on a scale from 0 to 100, where 100 is the best possible experience the doctor scale was 82 and the nursing scale 81. Users reported least positive experiences with the organization of the casualty clinic, with a scale score of 65. Self perceived health was associated with user satisfaction, while self perceived health and age were associated with user reported experiences with organization of the clinics. A range of user reported experience domains were related to user satisfaction, after controlling for socio-demographic variables, including experiences with doctor services at the clinics, organization of the clinics, information and self perceived incorrect treatment.
Users report positive experiences with the three casualty clinics, with organization as the aspect with largest improvement potential. The importance of age and health status for users' experiences and satisfaction with casualty clinics was shown, but a range of user reported experiences with the clinics were the most important predictors for user satisfaction.
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The aim of this study was to test the association between the rates of patient-reported incidents and patient harm documented in the patient record.
The study was a secondary analysis of two national hospital assessments conducted in 2011.
Hospital services in Norway.
The patient survey was a standard national patient-experience survey conducted at the hospital level for all 63 hospitals in Norway. The medical record review was performed by 47 Global Trigger Tools (GTTs) in all 19 hospital trusts and 4 private hospitals. The two data sets were matched at the unit level, yielding comparable patient experiences and GTT data for 7 departments, 16 hospitals and 11 hospital trusts.
No intervention.
The correlation at the unit level between the patient-reported incident in hospital instrument (PRIH-I) and estimated rates of patient harm from the GTT.
The PRIH-I index was significantly correlated with all patient-reported experience indicators at the individual level, with estimates for all patient harm events (Categories E-I) at the unit level (r = 0.62, P
Associations between adolescent experiences, parent experiences and HbA1c: results following two surveys based on the Norwegian Childhood Diabetes Registry (NCDR).
The aim of the current study was to determine the association between the experiences of adolescents and their parents with paediatric diabetes care at hospital outpatient departments and the association between these experiences and the Hemoglobin A1c (HbA1c) levels of adolescents.
Cross-sectional survey.
Paediatric diabetes care at hospital outpatient departments in Norway.
Parents of all outpatients registered in the Norwegian Childhood Diabetes Registry and patients in the same registry aged 12-17 years.
1399 parents participated in a national pilot survey and 335 patients aged 12-17 years from the four largest paediatric outpatient departments in Norway responded in another pilot study. 181 paired parental and patient questionnaires were analysed.
The correlations between single items, indicator scores and overall scores were explored, as was that between indicator scores and HbA1c levels.
There was a moderate but significant correlation between the responses of the patients and parents. For 40 of the 42 associations the correlations were significant, ranging from 0.16 to 0.42. A weak but significant negative correlation was found between the indicator scores of parents and the HbA1c levels of the adolescents. The strongest correlations were between HbA1c level and nurse contact and organisation, both with a correlation coefficient of 0.21 (p
A general trend towards positive patient-reported evaluations of hospitals could be taken as a sign that most patients form a homogeneous, reasonably pleased group, and consequently that there is little need for quality improvement. The objective of this study was to explore this assumption by identifying and statistically validating clusters of patients based on their evaluation of outcomes related to overall satisfaction, malpractice and benefit of treatment.
Data were collected using a national patient-experience survey of 61 hospitals in the 4 health regions in Norway during spring 2011. Postal questionnaires were mailed to 23,420 patients after their discharge from hospital. Cluster analysis was performed to identify response clusters of patients, based on their responses to single items about overall patient satisfaction, benefit of treatment and perception of malpractice.
Cluster analysis identified six response groups, including one cluster with systematically poorer evaluation across outcomes (18.5% of patients) and one small outlier group (5.3%) with very poor scores across all outcomes. One-Way ANOVA with post-hoc tests showed that most differences between the six response groups on the three outcome items were significant. The response groups were significantly associated with nine patient-experience indicators (p
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Cites: Int J Qual Health Care. 2006 Sep;18 Suppl 1:5-1316954510
Questionnaires are commonly used to collect patient, or user, experiences with health care encounters; however, their adaptation to specific target groups limits comparison between groups. We present the construction of a generic questionnaire (maximum of ten questions) for user evaluation across a range of health care services.
Based on previous testing of six group-specific questionnaires, we first constructed a generic questionnaire with 23 items related to user experiences. All questions included a "not applicable" response option, as well as a follow-up question about the item's importance. Nine user groups from one health trust were surveyed. Seven groups received questionnaires by mail and two by personal distribution. Selection of core questions was based on three criteria: applicability (proportion "not applicable"), importance (mean scores on follow-up questions), and comprehensiveness (content coverage, maximum two items per dimension).
1324 questionnaires were returned providing subsample sizes ranging from 52 to 323. Ten questions were excluded because the proportion of "not applicable" responses exceeded 20% in at least one user group. The number of remaining items was reduced to ten by applying the two other criteria. The final short questionnaire included items on outcome (2), clinician services (2), user involvement (2), incorrect treatment (1), information (1), organisation (1), and accessibility (1).
The Generic Short Patient Experiences Questionnaire (GS-PEQ) is a short, generic set of questions on user experiences with specialist health care that covers important topics for a range of groups. It can be used alone or with other instruments in quality assessment or in research. The psychometric properties and the relevance of the GS-PEQ in other health care settings and countries need further evaluation.
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Cites: Health Expect. 2010 Sep;13(3):285-9720550597
Patient experiences are acknowledged as an important aspect of health care quality but no validated instruments have been identified for the measurement of either parent or patient experiences with outpatient paediatric diabetes care. The aim of the current study was to assess the psychometric properties of a new instrument developed to measure parent experiences of paediatric diabetes care at hospital outpatient departments in Norway.
The development of the questionnaire was based on a literature review of existing questionnaires, qualitative interviews with both parents and children/adolescents, expert-group consultations, pretesting of the questionnaire and a pilot study. The national pilot study included parents of 2606 children/adolescents aged 0-17 years with Type 1 Diabetes registered in The Norwegian Childhood Diabetes Registry, a nationwide, population-based registry. Levels of missing data, ceiling effects, factor structure, internal consistency, item discriminant validity and construct validity were assessed.
A total of 2606 patients were included in the survey, but 80 were excluded due to incorrect addresses. 1399 (55%) parents responded to the questionnaire. Low levels of missing or "not applicable" responses were found for 31 of the 35 items (
Patient experiences questionnaire for interdisciplinary treatment for substance dependence (PEQ-ITSD): reliability and validity following a national survey in Norway.
Patient experiences are an important aspect of health care quality, but there is a lack of validated instruments for their measurement in the substance dependence literature. A new questionnaire to measure inpatients' experiences of interdisciplinary treatment for substance dependence has been developed in Norway. The aim of this study was to psychometrically test the new questionnaire, using data from a national survey in 2013.
The questionnaire was developed based on a literature review, qualitative interviews with patients, expert group discussions and pretesting. Data were collected in a national survey covering all residential facilities with inpatients in treatment for substance dependence in 2013. Data quality and psychometric properties were assessed, including ceiling effects, item missing, exploratory factor analysis, and tests of internal consistency reliability, test-retest reliability and construct validity.
The sample included 978 inpatients present at 98 residential institutions. After correcting for excluded patients (n?=?175), the response rate was 91.4%. 28 out of 33 items had less than 20.5% of missing data or replies in the "not applicable" category. All but one item met the ceiling effect criterion of less than 50.0% of the responses in the most favorable category. Exploratory factor analysis resulted in three scales: "treatment and personnel", "milieu" and "outcome". All scales showed satisfactory internal consistency reliability (Cronbach's alpha ranged from 0.75-0.91) and test-retest reliability (ICC ranged from 0.82-0.85). 17 of 18 significant associations between single variables and the scales supported construct validity of the PEQ-ITSD.
The content validity of the PEQ-ITSD was secured by a literature review, consultations with an expert group and qualitative interviews with patients. The PEQ-ITSD was used in a national survey in Norway in 2013 and psychometric testing showed that the instrument had satisfactory internal consistency reliability and construct validity.
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Cites: Am J Addict. 2002 Fall;11(4):291-30712584872
The objective of this study was to test the data quality, test-retest reliability and hospital-level reliability of the Patient-Reported Incident in Hospital Instrument (PRIH-I).
13 incident questions were included in a national patient-experience survey in Norway during the spring of 2011. All questions and a composite incident index were assessed by calculating missing-item rates, test-retest reliability and hospital-level reliability. A multivariate linear regression on a global item regarding incorrect treatment was used to assess the main sources of variation in patient-perceived incorrect treatment at hospitals.
Five of the 13 patient-incident questions had a missing-item rate of >20%. Only one item met the criterion of 0.7 for test-retest reliability (wrong or delayed diagnosis), seven items had a score of >0.5, while the remainder had a reliability score of 0.7 for six of 10 items tested at the hospital level, and >0.6 for the remaining four items. A patient-incident index based on 12 of the incident items had no missing data, the test-retest reliability was 0.6 and the hospital-level reliability was 0.85.
The PRIH-I comprises 13 questions about patient-perceived incidents in hospitals, and can be easily and cost-effectively included in national patient-experience surveys with an acceptable increase in respondent burden. Although the missing-item rate and test-retest reliability were poor for several items, the hospital-level reliability was satisfactory for most of the items. The incident items contribute to a patient-reported incident index, with excellent data quality and hospital-level reliability.
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The Psychiatric Inpatient Patient Experience Questionnaire (PIPEQ) was developed for post-discharge measurements of experiences, but the low response rates associated with post-discharge surveys restrict their usefulness. A new questionnaire was developed based on the PIPEQ for on-site measurements of patient experiences: the PIPEQ-OS. The aim of this study was to psychometrically test the PIPEQ-OS using data from a nationally representative survey conducted in Norway in 2014.
Data were collected using a nationally representative patient-experience survey; 25% of the institutions in each of the 4 health regions in Norway were randomly selected, yielding a total of 26 institutions. The PIPEQ-OS questionnaire was completed by patients on-site on an agreed day in week 37 of 2014. Item missing and ceiling effects were assessed, and factor analysis was used to assess the structure of the items included in the PIPEQ-OS. The scales were tested for internal consistency reliability, test-retest reliability and construct validity.
The initial sample comprised 857 patients. Of these, 60 were excluded for ethical reasons and 57 were excluded because they were absent on the day of the survey. Of the remaining 740 patients, 552 (74.6% of the included population) returned the questionnaire. Low levels of missing or "not applicable" responses were found for 18 of the 21 items (
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Cites: Int J Qual Health Care. 2014 Dec;26(6):592-60525142685
Cites: Qual Manag Health Care. 2014 Jul-Sep;23(3):178-8724978167
Introduction: There have been substantial alterations in the structure of postpartum care over the last several decades. Our aim was to investigate the perceived quality of, and satisfaction with, postpartum care among caregivers and care receivers in the maternity ward of a community hospital in Norway with about 2600 births per year. Methods: We conducted a cohort study of women giving birth and the caregiving staff in the maternity ward during a 7-month period. A questionnaire, with a Cronbach a coefficient above 0.8, was filled in anonymously, both by the staff in the ward and by the women. The questionnaire explored the respondents' evaluations of the information offered by the staff; the teaching of skills in child care and establishment of breastfeeding; assistance with practical tasks like making beds, serving meals, and keeping order in the room; visiting rules; level of noise in the ward; whether the pediatric service was adequate; length of the stay; and to what extent caregivers were able to respond to the individual needs of the mothers. Finally, the questionnaire explored the degree of kindliness communicated by the staff. Five extra questions in the women's questionnaire explored their personal experiences in the ward. Results: The care receivers' evaluations of the maternity ward did not differ significantly from that of the caregivers in questions related to overall care and service. However, the mothers rated the importance of assistance with child care during the night significantly higher than did the staff. Responses to questions addressing noise in the ward demonstrated a higher tolerance among the mothers compared with the staff. In addition, mothers tended (but not a statistically significant result) to rate the quality of the teaching of child-care skills lower, compared with the staff's ratings. Discussion: By exploring both the caregivers' and care receivers' evaluations and expectations of the actual services in the maternity ward, areas for enhancement of the quality of the ward and its services can be detected and carried out. The present study revealed 2 areas needing further focus: assistance with child care during the night and teaching of child-care skills during the stay. We believe that investigations that collect data from both caregivers and care receivers, by using adapted and validated questionnaires to gather information on quality and satisfaction with the maternity ward, are mandatory for improvement and continuous adaptation of health services.
