When it comes to getting an accurate take on patient experience with physical therapy, it may be a matter of the less asked, the better.
That's one of the conclusions reached in a Norwegian study that analyzed physical therapist (PT) patient surveys to find out whether a lengthy multidimension instrument could be simplified. Researchers used factor analysis to study results from a 41-item survey administered to 2,221 patients from 52 physical therapy practices, and found that more than a third of the questions did not yield meaningful results. Additionally, they discovered that the survey's 10 topical areas ("dimensions") could be reduced to 3: personal interaction, practice organization, and outcome. Results were published in the June 18 issue of BioMed Central (.pdf), an open-access journal.
"Quality of care from the patient's perspective is increasingly in the spotlight, but what exactly does it mean?" authors write. Often, they argue, it's hard to extract meaningful data from lengthy patient surveys that attempt to cover too much ground—respondents are quickly fatigued and tend to be less discerning in their answers, resulting in high overall scores and little variance. With these kinds of scores, authors write, "it becomes very difficult to distinguish high performing practices from practices with lower quality of care."
Researchers started by administering a 10-dimension, 41-item questionnaire that included areas such as accessibility, accommodation, communication, "physical therapist's approach," and "patient-centeredness," among others. Through an analysis of the performance of individual items in each dimension, researchers were able to identify the items that were consistently high-rated, with minimal (or no) variation. Once these were set aside, authors examined the remaining questions and determined that they could be regrouped into a much more straightforward, 3-dimension set of 28 questions that got to the heart of patient experience.
Authors suggest that the streamlined questionnaire could be administered "every 3 years or so" to a random sample of a practice's patients. They also recommend that practices include "a visible and mandatory complaint desk (physical or digital) … to monitor the quality of care at all times."
"Sharpening the definitions of the patient's perspective will help better measure the quality of care," authors write. "Patients do not benefit from too many vaguely formulated dimensions, but with 3 clear dimensions they can compare practices with ease on the dimensions they value the most."
Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.
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