Development of validated, context-specific patient-reported experience measures (PREMs) tools to enhance quality and patient safety in India.

Abstract

Objectives: Patient-reported experience measures (PREMs) offer unique insights into patient perceptions of care. However, their implementation at the micro level with regards to patient safety remains limited. This study aimed to repurpose PREMs to co-produce validated, context-specific PREMs tools aimed at improving patient safety.

Methods: A prospective mixed method approach was used to design PREMs-based tools. This multiphase study was conducted from September 2023 to April 2024. In phase 1, a core group identified 17 key processes to devise the PREMs tools. In phase 2, focus group discussions were conducted by the multidisciplinary principal teams to finalise the standard operating procedures for each key process and prepare the respective PREMs questionnaires. Patient safety was the primary construct. Relevant stakeholders, including patients, participated in the face and content validation of each PREMs tool during phase 3. Content Validity Index (CVI) was calculated using three indices, namely, item level CVI (I-CVI), scale-level CVI (S-CVI) and content validity ratio (CVR). The reliability of the questionnaires was checked using Kuder-Richardson Formula 20 (KR-20) values with pilot tests on patients.

Results: 17 checklist format PREMs tools were developed. The I-CVI values for all the items in the questionnaires ranged from 0.73 to 1.00 and the CVR values ranged from 0.46 to 1.00. The S-CVI/AVG ranged from 0.89 to 1.00. These indicated strong content validity for all items and questionnaires. The reliability analysis for the 17 studies, based on the KR-20 values, ranged from 0.4324 to 0.9455. Except for 'fall prevention', all tools showed good internal consistency.

Conclusions: We offer a battery of patient safety oriented PREMs tools. Co-production of PREMs tools across an extensive range of patient care processes offers significant potential in patient safety implementation in addition to patient engagement.