Quality of acute internal medicine: A patient-centered approach. Validation and usage of the Patient Reported Measure-acute care in the Netherlands

• Published in: PloS one 2020-12, Vol.15 (12), p.e0242603-e0242603
• Main Authors: Kremers, Marjolein N T, Mols, Elsemieke E M, Simons, Yvonne A E, van Kuijk, Sander M J, Holleman, Frits, Nanayakkara, Prabath W B, Haak, Harm R
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biology and Life Sciences; Chronic illnesses; Critical Care; Domains; Emergency medical care; Emergency medical services; Emergency Service, Hospital - standards; Evaluation; Family physicians; Female; Health services; Hospitals; Humans; Internal medicine; Internal Medicine - trends; Interviews; Long term health care; Male; Medical care quality; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Netherlands - epidemiology; Patient Reported Outcome Measures; Patient Satisfaction - statistics & numerical data; Patient-centered care; Patient-Centered Care - standards; Patients; People and Places; Primary care; Psychometrics - trends; Public health; Quality control; Quality Improvement; Quality management; Quality of care; Quality of Health Care - standards; Quality of Life; Questionnaires; Social Sciences; Statistical analysis; Subgroups; Supervision; Surveys and Questionnaires; Validity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0242603

Providing high quality care is important and has gained more attention since the introduction of value-based healthcare. Value should be measured by outcomes achieved, relevant for patients. Patient-centeredness is one domain for quality improvement determined by the Institute of Medicine, aiming to deliver care responsive to the patient. The development and implementation of patient reported outcome- and experience measures can be used for this goal. Recently, we developed the Patient Reported Measure (PRM)-acute care, based on five relevant domains to evaluate and improve the quality of care in the Emergency Department (ED). To validate the PRM-acute care, in order to evaluate and improve patient-centered care in the ED. We performed a prospective questionnaire-based study. Patients ≥18 years presenting for internal medicine in the ED were eligible. The validity of the PRM-acute care was evaluated according to the COSMIN-criteria. We performed hypotheses testing to evaluate construct validity. The perceived quality of care was evaluated by statistical analysis. Face- and content validity was evaluated based on previously performed research and deemed good. Construct validity was supported by demonstrated differences between subgroups; patients with severe symptoms had a higher perceived quality of care. The correlation between overall satisfaction and the total mean score of the PRM-acute care (r = 0,447, p = 0.01) was significant. Overall, patients reported a mean perceived quality of care of 4.67/6.0. The PRM-acute care is a valid instrument to measure the perceived quality of care in an acute setting for internal medicine patients. Additionally, patients reported a good perceived quality of care in the ED with scores ranging from moderate to well for each of the relevant domains. Therefore, we believe that the PRM-acute care can be implemented in daily practice to evaluate the perceived quality of care and to improve the quality of acute care.