Evaluating clinician experience in value-based health care: the development and validation of the Clinician Experience Measure (CEM)

BMC Health Services Research

Research

Rebecca Mitchell¹  Glen Maberly²  Reema Harrison³  Louise Ellis⁴  Elizabeth Manias⁵  Ramesh Walpola⁶  Ben Roxas-Harris⁶  Timothy Dobbins⁶  Laurel Mimmo⁷  Catherine Chan⁸  Liz Hay⁸  Sharyn Cowie⁹ 

[1] Australian Institute of Health Innovation, Macquarie University, 2109, Sydney, NSW, Australia;Blacktown and Western Sydney Local Health District, 2151, North Parramatta, NSW, Australia;Centre for Health Systems and Safety, Australian Institute of Health Innovation, Macquarie University, Lvl 6, 75 Talavera Road, 2109, Sydney, NSW, Australia;Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 2109, Sydney, NSW, Australia;Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton Campus, Wellington Road, 3800, Clayton, Victoria, Australia;Deakin University, Burwood, Australia;School of Population Health, UNSW Sydney, 2052, Sydney, Australia;School of Women’s and Children’s Health, UNSW, 2052, Sydney, Australia;Strategic Reform Branch, NSW Ministry of Health, 2065, Sydney, NSW, Australia;Western NSW Local Health District, 2880, Broken Hill, NSW, Australia;

关键词: Clinician experience measurement;    Value-based healthcare;    Health services;    Survey;    Psychometrics;    Validity;    Reliability;   

DOI  :  10.1186/s12913-022-08900-8

 received in 2022-04-19, accepted in 2022-11-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundClinicians’ experiences of providing care constitute an important outcome for evaluating care from a value-based healthcare perspective. Yet no currently available instruments have been designed and validated for assessing clinicians’ experiences. This research sought to address this important gap by developing and validating a novel instrument in a public health system in Australia.MethodsA multi-method project was conducted using co-design with 12 clinician leaders from a range of NSW Health Local Health Districts to develop the Clinician Experience Measure (CEM). Validity and reliability analyses were conducted in two stages, first assessing face and content validity with a pool of 25 clinicians and then using psychometric analysis with data from 433 clinicians, including nurses, doctors and allied health and representing all districts within one jurisdiction in Australia.ResultsData gathered from 25 clinicians via the face and content validity process indicated that the initial 31-items were relevant to the range of staff employed in the NSW state health system, with minor edits made to the survey layout and wording within two items. Psychometric analysis led to a rationalised 18-item final instrument, comprising four domains: psychological safety (4-items); quality of care (5-items); clinician engagement (4-items) and interprofessional collaboration (5-items). The 18-item four-factor model produced a good fit to the data and high levels of reliability, with factor loadings ranging from .62 to .94, with Cronbach’s alpha (range: .83 to .96) and composite reliability (range: .85 to .97).ConclusionsThe CEM is an instrument to capture clinicians’ experiences of providing care across a health system. The CEM provides a useful tool for healthcare leaders and policy makers to benchmark and assess the impact of value-based care initiatives and direct change efforts.

【 授权许可】

CC BY   
© The Author(s) 2022