WatLX©: Development and validation of a cross-continuum rehabilitative care patient experience instrument

Abstract

Introduction: As health care systems move to integrate service delivery between settings and providers in geographic regions, oversight and funding bodies are beginning to explore methods of measuring patients overall experience of a health care system, as well as its individual service delivery organisations. Integrated care, comprising successful transitions and communication between health service organizations, and positive experiences with providers is particularly important for rehabilitative care clients, where continuity of care and treatment adherence impact outcomes. Methods: Using the results of a comprehensive and systematic review of psychometrically tested rehabilitative care experience measures and data collection instruments (McMurray et al., 2015a, 2015b), we created an inventory of 508 questions and identified six themes that represented key patient experience constructs. A parsimonious set of questions that focussed on key constructs by themes was tested for content and face validity using focus groups with rehabilitative care patients and their informal caregivers, and contributions from rehabilitative care experts. Cognitive interviewing was used to test the questionnaire usability and user interface. Construct validity and reliability testing (inter-item correlation & test-retest reliability) is in progress *with a small pilot sample of rehabilitative care clients. Results: A ten item questionnaire was tested using cognitive interviewing with 12 patients (3 rounds of 4 participants each) and three progressively edited versions of the WatLX© questionnaire. A final version required no further modifications, and is currently undergoing psychometric testing. Results will be available and presented at the conference. A final version of the WatLX© survey will be shared with delegates. Discussion: Rehabilitative care clients have characteristics that differentiate their experience from that of other sectors and patient groups, warranting a customized patient experience framework and dedicated data collection instrument. Many patient experience instruments focus on just one care provider in a care system, and use large question panels that may incur low response rates. The survey instrument developed in this research study provides a parsimonious set of questions that address strategic issues in the ongoing improvement of care delivery and the patient experience in the rehabilitative care sector. Conclusion: The WatLX© rehabilitative care patient experience survey instrument has undergone successful content and face validation, and is currently undergoing construct validation with a sample population of rehabilitative care clients. Next Steps: A pilot test of the WatLX© will start in 2016 with a population of out-patient rehabilitative care clients. As 85% of care in Canada occurs at the community level (Canadian Medical Association, 2010), the research team is developing a mobile application that will allow in-situ collection of patient experience data immediately after a service encounter. This application is expected to provide a more immediate, accurate and insightful level of understanding service quality, and address the issues of recall bias, retention and responsiveness with traditional survey modalities.