Development and pilot multicentre evaluation of a patient-reported experience measure for acute ischemic stroke care.

Abstract

The quality of stroke care is typically assessed using clinical outcomes defined by healthcare professionals. Patient-Reported Experience Measures (PREMs) can provide additional valuable insights into patients' experiences of care processes. However, existing stroke PREMs have limitations in assessing the experiences of patients with ischemic stroke. Therefore, this study aimed to develop and evaluate a PREM specifically for this patient population. A new PREM was developed, partially based on existing instruments. Stakeholders in the field participated in the selection process, after which the PREM was implemented in a multihospital pilot setting. To evaluate feasibility and reliability, we assessed (non-)response, extreme-category concentration, inter-item correlations, and Cronbach's alpha. Exploratory factor analysis (EFA) was conducted. The 26-item survey was evaluated across nine Flemish hospitals. The PREM-questionnaire was distributed to 277 patients, of whom 165 completed the survey, resulting in a 60% response rate. Missing values were below the 10% threshold, and no sociodemographic differences were observed between respondents and non-respondents. No concentration in extreme response categories was observed, supporting the instrument's ability to discriminate between respondents. Results of the EFA (n = 105) were exploratory and require conformation in a larger sample. The newly developed PREM for patients with ischemic stroke represents a practical update to existing PREMs. The findings support its feasibility, as reflected by the 60% response rate, and provide preliminary evidence of its reliability. Further evaluation of the survey's psychometric properties, including patient-led validation, is required before general implementation can be considered.