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Multicenter validation of the Quality of Trauma Care Patient-Reported Experience Measure (QTAC-PREM)

Bobrovitz, Niklas MSc; Santana, Maria J. MPharm, PhD; Kline, Theresa PhD; Kortbeek, John MD; Widder, Sandy MD, MHA; Martin, Kevin MD; Stelfox, Henry T. MD, PhD

Journal of Trauma and Acute Care Surgery: January 2016 - Volume 80 - Issue 1 - p 111–118
doi: 10.1097/TA.0000000000000879
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BACKGROUND Incorporating patient and family perspectives into injury care quality assessment is a necessary part of comprehensive quality improvement. However, tools to measure patient and family perspectives of injury care are lacking. Therefore, our objective was to assess the psychometric properties of the Quality of Trauma Care Patient-Reported Experience Measure (QTAC-PREM), the first measure developed to assess patient experiences with overall injury care.

METHODS We conducted a prospective multicenter cohort study of adult injury patients recruited from three trauma centers. Patients or surrogates completed an acute care survey measure in the hospital and a post–acute care survey measure after hospital discharge.

RESULTS Four hundred participants (78%) completed the acute care measure, and 207 (59%) completed the post–acute care measure. We identified three subscales on the acute measure and two subscales on the post–acute measure. All subscales and items had evidence of construct validity. Four subscales had good internal consistency, and three were independent predictors of participants’ overall ratings of injury care quality. The majority of items demonstrated suitable test-retest reliability. Comparison of QTAC-PREM scores with those of an existing patient experience tool, the Hospital version of the Consumer Assessment of Healthcare Providers and Systems (HCAHPS), demonstrated evidence of appropriate divergent and convergent validity.

CONCLUSION This study demonstrates that the QTAC-PREM is feasible to implement at trauma centers and provides evidence of validity and reliability. The tool may be useful to incorporate patient perspectives into trauma care quality measurement and improvement.

Supplemental digital content is available in the text.

From the Nuffield Department of Primary Care Health Sciences (NB), University of Oxford, Oxford, United Kingdom; Department of Community Health Sciences (N.B., M.J.S., H.T.S.), W21C Research and Innovation Centre (M.J.S.), Department of Psychology (T.K.), Department of Surgery (J.K.), Department of Critical Care Medicine (H.T.S.), and Department of Medicine (H.T.S.), University of Calgary, Calgary, Alberta; Division of General Surgery (S.W.), Department of Surgery (S.W.), Division of Critical Care Medicine (S.W.), University of Alberta, Edmonton; and Chinook Regional Hospital (K.M.), Lethbridge, Canada.

Submitted: June 17, 2015, Revised: July 19, 2015, Accepted: July 23, 2015.

Funding sources had no role in the design of this study and had no role in the conduct or reporting of this study.

N.B. and H.T.S. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.jtrauma.com).

Address for reprints: Niklas Bobrovitz, MSc, Nuffield Department of Primary Care Health Sciences, University of Oxford, 2nd Floor, Radcliffe Observatory Quarter Woodstock Rd, Oxford, United Kingdom OX2 6GG; email: niklas.bobrovitz@phc.ox.ac.uk.

© 2016 Lippincott Williams & Wilkins, Inc.