Darzi review: Reward hospitals for improving quality, Lord Darzi says

Measuring patient experience: a systematic review to evaluate psychometric properties of patient reported experience measures (PREMs) for emergency care service provision

PURPOSE

Knowledge about patient experience within emergency departments (EDs) allows services to develop and improve in line with patient needs. There is no standardized instrument to measure patient experience. The aim of this study is to identify patient reported experience measures (PREMs) for EDs, examine the rigour by which they were developed and their psychometric properties when judged against standard criteria.

DATA SOURCES

Medline, Scopus, CINAHL, PsycINFO, PubMed and Web of Science were searched from inception to May 2015.

STUDY SELECTION

Studies were identified using specific search terms and inclusion criteria. A total of eight articles, reporting on four PREMs, were included.

DATA EXTRACTION

Data on the development and performance of the four PREMs were extracted from the articles. The measures were critiqued according to quality criteria previously described by Pesudovs K, Burr JM, Harley C, et al. (The development, assessment, and selection of questionnaires. Optom Vis Sci 2007;84:663-74.).

RESULTS

There was significant variation in the quality of development and reporting of psychometric properties. For all four PREMs, initial development work included the ascertainment of patient experiences using qualitative interviews. However, instrument performance was poorly assessed. Validity and reliability were measured in some studies; however responsiveness, an important aspect on survey development, was not measured in any of the included studies.

CONCLUSION

PREMS currently available for use in the ED have uncertain validity, reliability and responsiveness. Further validation work is required to assess their acceptability to patients and their usefulness in clinical practice.

The challenge for academic health partnerships

The future of academic medicine in Australia has been identified as a significant issue, but received little mention in the interim report of the National Health and Hospitals Reform Commission. Australia is at particular risk of failing to capitalise on what is happening globally with academic medicine. New "partnerships" between health services, universities and health research institutes should be encouraged for stimulating research and learning across the health sector. Such partnerships can drive translational research, provide full costing of research, and establish national and international networks of researchers and research funding. There are many interactions between Australian state and federal jurisdictions and their hospitals and primary care organisations, but these are often loosely coordinated and with little understanding of how universities and research institutes can help to deliver better and more efficient health care. Academic health science centres, as recently designated by the National Health Service in the United Kingdom, provide a useful model for consideration in Australia.