Abstract
The recently developed Child HCAHPS provides a standard to measure US hospitals’ performance on pediatric inpatient experiences of care. We field-tested Child HCAHPS in Belgium to instigate international comparison. In the development stage, forward/backward translation was conducted and patients assessed content validity index as excellent. The draft Flemish Child HCAHPS included 63 items: 38 items for five topics hypothesized to be similar to those proposed in the US (communication with parent, communication with child, attention to safety and comfort, hospital environment, and global rating), 10 screeners, a 14-item demographic and descriptive section, and one open-ended item. A 6-week pilot test was subsequently performed in three pediatric wards (general ward, hematology and oncology ward, infant and toddler ward) at a JCI-accredited university hospital. An overall response rate of 90.99% (303/333) was achieved and was consistent across wards. Confirmatory factor analysis largely confirmed the configuration of the proposed composites. Composite and single-item measures related well to patients’ global rating of the hospital. Interpretation of different patient experiences across types of wards merits further investigation.
Conclusion: Child HCAHPS provides an opportunity for systematic and cross-national assessment of pediatric inpatient experiences. Sharing and implementing international best practices are the next logical step.
What is Known: • Patient experience surveys are increasingly used to reflect on the quality, safety, and centeredness of patient care. • While adult inpatient experience surveys are routinely used across countries around the world, the measurement of pediatric inpatient experiences is a young field of research that is essential to reflect on family-centered care. |
What is New: • We demonstrate that the US-developed Child HCAHPS provides an opportunity for international benchmarking of pediatric inpatient experiences with care through parents and guardians. • Our study findings show considerable variation in experiences for types of pediatric services. Support to share good practices and launch quality improvement initiatives can be obtained by organizing regular two-way feedback sessions with clinicians to place the findings in context. |
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Abbreviations
- CFA:
-
confirmatory factor analysis
- CFI:
-
comparative fit index
- CVI:
-
content validity index
- (H)CAHPS:
-
(Hospital) Consumer Assessment of Healthcare Providers and Systems
- JCI:
-
Joint Commission International
- NQF:
-
National Quality Forum
- RMSEA:
-
root means square error of approximation
- TLI:
-
Tucker Lewis index
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Acknowledgements
The authors are grateful to Ms. Charlotte Van der Auwera and Ms. Katrien Huygen for early help in data collection.
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LB and KVH coordinated the research. All authors made contributions to the design of the study and study protocol. LB, EC, GB, KC, BL and JVDS acquired data. LB performed the statistical computations. LB, EC and KVH drafted the manuscript. All authors analysed and interpreted the data, revised the content of the manuscript, and approved the final manuscript to be published.
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No funding was received for this study. The authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Communicated by Mario Bianchetti
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Bruyneel, L., Coeckelberghs, E., Buyse, G. et al. Validation of the Child HCAHPS survey to measure pediatric inpatient experience of care in Flanders. Eur J Pediatr 176, 935–945 (2017). https://doi.org/10.1007/s00431-017-2919-7
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DOI: https://doi.org/10.1007/s00431-017-2919-7