Validation and Adjustment of the Patient Experience Questionnaire (PEQ): A Regional Hospital Study in Norway

Validating perceptions with clinical measures: A latent growth curve on the associations between patient experience and hospital-associated infections in Norway over time

OBJECTIVE

The aim of the study was to examine the parallel relationships between the growth rates of patient-reported experiences and hospital-associated infections (HAIs) over time.

DATA SOURCES/STUDY SETTING

The study employed five waves (years) of data among hospitals across Norway from the Norwegian Health Directorate website for both patient experience and HAIs.

STUDY DESIGN

The study employed a longitudinal design, testing and comparing different models. A latent growth curve model with autoregressions emerged as the best fit for the data.

DATA COLLECTION/EXTRACTION METHODS

The data extracted from the website included 102 hospitals. However, the study used 61 hospitals after data cleaning, each with 400 patient respondents for each year.

PRINCIPAL FINDINGS

The results showed that for both patient experiences and HAIs, hospitals that recorded higher scores at the starting point experienced a lower growth rate over time compared to hospitals that recorded lower infections at the starting point. Second, it was found that the starting point for patient experience significantly related to the starting point for HAIs, such that the higher the score for patient experience, the lower the score on infections across hospitals. The results also indicated that almost all lagged effects on either patient-reported experience or HAIs were significant.

CONCLUSIONS

This study shows the significance of patient experience, not only for patient-reported outcomes but also for clinical outcomes. This thus ascertains the relevance of the patient experience pillar for the other pillars of quality health care, namely, clinical effectiveness and safety.

A qualitative analysis of free-text patient satisfaction responses in Care Response, a database of patient-reported outcome and experience measures

BACKGROUND

Databases have become important tools in improving health care. Care Response is a database containing information on tens of thousands of chiropractic patients internationally. It has been collecting patient-reported outcomes and patient satisfaction information for more than 10 years. The purpose of this study was to contribute to the understanding of patient perceptions and priorities for chiropractic care by analysing free text entered into the patient reported experience measure (PREM) questionnaires within the Care Response system.

METHODS

There were two questions of interest on the PREM for this study. One requested information about "good points" patients perceived about patients' care experience, and the other requested information on "improvements" that could make the experience better. We conducted a word frequency analysis using a word counting macro in Microsoft Word, then used those results as a starting point for a qualitative analysis. Data were collected on 30 May 2022.

RESULTS

The people who participated in the Care Response system often reported positive experiences with their chiropractors, including that they had reduced pain, improved function, and felt validated in their clinical condition. In addition, they appreciated having diagnostic and treatment procedures explained to them. They valued friendly, professional, and on-time service. The negative experiences were the opposite: being rushed through treatment, that the treatment was not worth the cost, or that they weren't treated professionally, empathetically, or with respect for them as individuals. The most important themes that emerged under "good points" were satisfaction (with care), value (as a person), safety, comfort, and professionalism. Their opposites, dissatisfaction, lack of value, lack of safety, lack of comfort, and lack of professionalism emerged as the most important themes under "improvements". We report some nuances of patient experience that have not previously been explored in the literature.

CONCLUSIONS

Respondents seemed to value effective care provided in a safe, professional, friendly, and aesthetically pleasing environment. Chiropractors should note these priorities and engage with patients according to them. Education institutions should consider how good practice in these areas might be incorporated into curricula.

A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients

BACKGROUND

Databases have become an important tool in understanding trends and correlations in health care by collecting demographic and clinical information. Analysis of data collected from large cohorts of patients can have the potential to generate insights into factors identifying treatments and the characteristics of subgroups of patients who respond to certain types of care. The Care Response (CR) database was designed to capture patient-reported outcome measures (PROMs) for chiropractic patients internationally. Although several papers have been published analysing some of the data, its contents have not yet been comprehensively documented. The primary aim of this study was to describe the information in the CR database. The secondary aim was to determine whether there was suitable information available to better understand subgroups of chiropractic patients and responsiveness to care. This would be achieved by enabling correlations among patient demographics, diagnoses, and therapeutic interventions with machine learning approaches.

METHODS

Data in all available fields were requested with no date restriction. Data were collected on 12 April 2022. The output was manually scanned for scope and completeness. Tables were created with categories of information. Descriptive statistics were applied.

RESULTS

The CR database collects information from patients at the first clinical visit, 14, 30, and 90 days subsequently. There were 32,468 patient responses; 3210 patients completed all fields through the 90 day follow up period. 45% of respondents were male; 54% were female; the average age was 49. There was little demographic information, and no information on diagnoses or therapeutic interventions. We received StartBack, numerical pain scale, patient global impression of change, and Bournemouth questionnaire data, but no other PROMs.

CONCLUSIONS

The CR database is a large set of PROMs for chiropractic patients internationally. We found it unsuitable for machine learning analysis for our purposes; its utility is limited by a lack of demographic information, diagnoses, and therapeutic interventions. However, it can offer information about chiropractic care in general and patient satisfaction. It could form the basis for a useful clinical tool in the future, if reformed to be more accessible to researchers and expanded with more information collected.

Competence Development and Collaborative Climate as Antecedents of Job Performance, Job Commitment and Uncertainty: Validation of a Theoretical Model across Four Hospitals

Knowledge is lacking regarding how organizational factors are associated with uncertainty in patient treatment. Thus, the aim of the current study was to investigate how competence development and collaborative climate relates to job performance and job commitment, and further whether job performance and job commitment relate to uncertainty. Additionally, we examined whether these associations differed between four different hospitals. We applied data from 6445 hospital workers who provided care to patients. Basic statistics and structural equation modelling (SEM) were used to test the validity of the theoretical model developed in the study and the hypothesized associations. All hypothesized paths between the latent variables were significant and in accordance with the model across the four hospitals. The current study has implications for practical human resource management and indicates that competence development should be strengthened at the individual level and collaborative climate should be strengthened at the ward level. Strengthening competence development and collaborative climate can increase job performance and job commitment of individual workers and reduce uncertainty during care in hospital settings.