Emergency Department Patient Experience of Care Survey

Emergency Department Patient Experience of Care Survey: Development and Field Test

Robin M. Weinick
Kirsten Becker
Layla Parast
Brian D. Stucky
Marc N. Elliott
Megan Mathews
Chris Chan
Virginia I. Kotzias
Copyright Date: 2014
Published by: RAND Corporation
Pages: 88
https://www.jstor.org/stable/10.7249/j.ctt14bs3sk
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  • Book Info
    Emergency Department Patient Experience of Care Survey
    Book Description:

    The Centers for Medicare & Medicaid Services have implemented Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys to assess patient experience in a number of settings. Following CAHPS principles, RAND researchers designed and field tested an Emergency Department Patient Experience of Care Survey that consists of three survey instruments for use with adult patients who have visited the emergency department.

    eISBN: 978-0-8330-8951-9
    Subjects: Health Sciences, History

Table of Contents

  1. Front Matter
    (pp. i-i)
  2. Preface
    (pp. ii-ii)
  3. Table of Contents
    (pp. iii-iv)
  4. Tables
    (pp. v-v)
  5. Summary
    (pp. vi-viii)
  6. Acknowledgments
    (pp. ix-ix)
  7. Abbreviations
    (pp. x-x)
  8. 1. Introduction
    (pp. 1-1)

    The Centers for Medicare & Medicaid Services (CMS) have implemented patient experience surveys in a number of settings, including traditional Medicare, Medicare Advantage, Part D Prescription Drug Plans, hospitals, in-center hemodialysis facilities, and home health agencies. While CMS and the Agency for Healthcare Research and Quality (AHRQ) have developed additional Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys for nursing homes and for clinician and group practices, none of these surveys address patients’ experiences with emergency department (ED) services.

    The ED is the site for 28 percent of all acute care visits in the United States¹ and is a...

  9. 2. Developing Survey Instruments for the Field Test
    (pp. 2-5)

    The content and design of the EDPEC Survey were informed by

    a call for topic areas published in the Federal Register

    a review of the literature, including publications in peer-reviewed journals and the gray literature

    focus groups with ED patients and caregivers of ED patients

    a technical expert panel (TEP)

    cognitive testing with ED patients.

    In response to a call for topic areas that was published in the Federal Register in December 2012,⁴ stakeholders suggested a number of substantive content areas for the survey, including

    overall quality of care provided in the ED and willingness of patients to recommend the...

  10. 3. Field Test
    (pp. 6-9)

    We used the American Hospital Association (AHA) database to identify a sample frame of all hospitals with EDs in the United States, excluding specialty-care hospitals and children’s hospitals. To ensure that the field test would be adequately powered and could be completed in the needed three-month time frame, we required that each of the 12 participating hospital EDs treat (1) at least 160 patients per month who are admitted to the hospital through the ED and (2) at least 240 patients per month who are discharged to the community. As a result, we also excluded those EDs with fewer than...

  11. 4. Response Rates, Respondent Characteristics, and Proxies
    (pp. 10-17)

    For each instrument and mode, Table 4.1 displays the total number of individuals sampled, confirmed ineligible, and eligible for the survey; the number with complete and partial responses; and our response rates. Our response rates were calculated using response rate #2 from the American Association for Public Opinion Research, which counts partially completed questionnaires as respondents.⁶

    Confirmed ineligibles comprised 5.38 percent of the total sample and were more prevalent among patients admitted to the hospital and in the telephone mode; this group includes cases where a family member confirmed by mail or telephone that the selected individual was deceased, residing...

  12. 5. Methods and Measurement
    (pp. 18-40)

    In this chapter, we present the results of our case-mix adjustment analyses, investigation of survey mode effects, assessment of reliability and missing data, and psychometric analyses.

    Throughout the remainder of this report, we refer to “evaluative questions” as those that ask respondents to report on their experience of care. Evaluative questions are asked only of respondents to whom they apply, and many are preceded by screener questions that identify which respondents should answer the question. For example:

    Screener question: “During this emergency room visit, were you given any medicine that you had not taken before?”

    Related evaluative question: “Before giving...

  13. 6. Patient Experience in the Emergency Department
    (pp. 41-47)

    Here we compare patient experience between those respondents who were discharged to the community and those who were admitted to the hospital following their ED visit. For each evaluative question included in the instruments for both groups, we compared weighted means on a 0-to-100 linear scale. For questions that were included on the Admitted HCAHPS Add-on instrument, we compared the Discharged to Community responses to those from both Admitted instruments combined. For all other questions, we compared responses to the Discharged to Community instrument to those from the Admitted Stand Alone instrument.

    For each evaluative question in common between the...

  14. 7. Changes Made to the Survey Instrument Following the Field Test
    (pp. 48-49)

    The following questions were removed from the Discharged to Community and Admitted Stand Alone survey instruments after the field test:

    “During this emergency room visit, was your family member or friend allowed to stay with you when you wanted them with you?” This question had a high ceiling effect, as a large proportion (95.09%) of respondents who had a family member or friend with them in the ED reported that this person was allowed to stay with them when wanted.

    ““During this emergency room visit, did you have a family member or friend with you?”

    This question served only to...

  15. 8. Draft Survey Instruments Following Field Test
    (pp. 50-51)

    In this section, we present the three English-language draft instruments resulting from the field test:

    Discharged to Community: 35 questions regarding ED experience, plus 18 questions regarding the respondent’s characteristics

    Admitted Stand Alone: 29 questions regarding ED experience, plus 18 questions regarding the respondent’s characteristics

    Admitted HCAHPS Add-on: 10 questions regarding ED experience that should be inserted into a full HCAHPS instrument (using the most recently available version of the instrument) immediately preceding the “About You” section that includes questions regarding the respondent’s characteristics.

    The 18 questions regarding the respondent’s characteristics in the Discharged to Community and Admitted Stand Alone...

  16. EDPEC Survey 2.0—Discharged to Community Instrument
    (pp. 52-60)
  17. EDPEC Survey 2.0—Admitted Stand Alone Instrument
    (pp. 61-69)
  18. EDPEC Survey 2.0—Admitted HCAHPS Add-on Instrument
    (pp. 70-74)
  19. References
    (pp. 75-77)