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Patient Experience Monitor (PEM): The Development of New Short-Form Picker Experience Questionnaires for Hospital Patients with a Wide Range of Literacy Levels

Authors Bastemeijer CM, Boosman H, Zandbelt L, Timman R, de Boer D, Hazelzet JA

Received 27 July 2020

Accepted for publication 13 October 2020

Published 30 November 2020 Volume 2020:11 Pages 221—230


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Lynne Nemeth

Carla M Bastemeijer,1 Hileen Boosman,2 Linda Zandbelt,3 Reinier Timman,4 Dolf de Boer,5 Jan A Hazelzet1

1Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands; 2Department of Quality & Patient Safety, Leiden University Medical Center, Leiden, the Netherlands; 3Department of Clinical and Executive Support, Amsterdam University Medical Centers, Amsterdam, the Netherlands; 4Department of Psychiatry, Unit of Medical Psychology & Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands; 5Care from the Patient Perspective, Nivel, Utrecht, the Netherlands

Correspondence: Carla M Bastemeijer
Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, CA 3000, the Netherlands
Tel +31 612601805

Purpose: Several patient-reported experience measures (PREMs) were developed through the years. These questionnaires are frequently found to be inappropriate for people with lower literacy levels. This paper describes the development of patient experience questionnaires for hospital patients with a wide range of literacy levels, while enabling the potential for quality improvement.
Methods: Mixed methods were used to adapt Picker Institute patient experience questionnaires: selection of items and adaptation towards language level B1 (the language level of which patients can express their own opinion and describe experiences, events and expectations) by expert panels, usability tests with patients, analysis of psychometric properties and member checking. A theory-driven approach was followed for definitive enrolment of items, meaning that the items eligible for exclusion had been carefully reviewed by the expert team and representatives of a patient council before definitive exclusion.
Results: A pilot study was performed in an University Medical Centre in the Netherlands among in- and outpatients after discharge. Two provisional questionnaires of 22 items, designed by an expert panel, were reduced towards a final selection of 14– 15 items. This led to two short-form questionnaires, called Patient Experience Monitor (PEM) Adult Inpatient and PEM Adult Outpatient. To illustrate, the results of the PEM Adult Outpatient questionnaire are presented.
Conclusion: PEMs are short and valid questionnaires specifically developed to measure patient experiences of hospital patients with a wide range of literacy levels. Acceptance of the questionnaires for both lower and higher educated patients are confirmed by usability tests. The respondents of the pilot study represent both groups. The developed questionnaires should be seen as a dynamic entity and part of a continuous effort to evaluate and improve patient experiences. Future studies are needed to examine the usability of these new questionnaires for quality improvement.

Keywords: patient experiences, quality in healthcare, patient centered care, PREM

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