Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT).
To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT.



Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used.



CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility.



CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28-0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact.



CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.
School of Health Sciences, University of Stirling, Centre for Health Science, Inverness, UK.
Michelle
M
Beattie
School of Health Sciences, University of Stirling, Stirling, UK.
Ashley
A
Shepherd
College of Nursing, University of South Florida, South Florida, Florida, USA.
William
W
Lauder
School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK.
Iain
I
Atherton
School of Health Sciences, University of Stirling, Stirling, UK.
Julie
J
Cowie
Quality, Safety and Informatics Research Group, University of Dundee, Dundee, UK.
Douglas J
DJ
Murphy
D005246:Feedback; D006761:Hospitals / Q000592:standards*; D006801:Humans; D017060:Patient Satisfaction; D025341:Principal Component Analysis; D011594:Psychometrics; D058996:Quality Improvement; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
instrument; patient experience; patient satisfaction; questionnaire; survey