Abstract
Background
Patient-Reported Experience Measures (PREMs) are validated self-reported perceptions of how patients experience care in a given context. Despite their recognized value, their integration in clinical settings is limited by conceptual heterogeneity and measurement inconsistency. To enhance comparability and operational clarity, this study aimed to develop a consensus-based core set of constructs representing the essential dimensions of patient experience in primary care.
Methods
We conducted a three-round Delphi study in accordance with the COS-STAD and ACCORD methodological standards. We purposively recruited experts into three groups: patients, clinicians/decision-makers, and researchers. Sixteen constructs derived from a prior scoping review of validated PREMs were rated for inclusion in a core measurement set. Consensus thresholds were defined a priori as a positive median, interquartile range?
Results
Eighty-nine experts participated across rounds (24 patients, 31 clinicians/decision-makers, 34 researchers). Of the sixteen constructs evaluated, six reached global consensus: accessibility, continuity, coordination, communication, comprehensiveness, and patient engagement. Subgroup analyses revealed convergence between patients and clinicians on these constructs in round 2, suggesting disciplinary heterogeneity in conceptualizing experience domains. Ten constructs did not achieve consensus, reflecting contextual or normative variability: including equity, advocacy, organization, professional competencies, family context, and community context.
Conclusion
This Delphi-derived core set provides a consensus-informed basis for measuring patient experience in primary care. It offers a parsimonious, conceptually grounded framework to guide PREM development, support data comparability, and enhance responsiveness within learning health systems. Context-dependent constructs should complement the core set where local priorities or populations warrant expanded assessment.
As in any care or service context, primary care is no exception to the importance of an adequate patient experience. It must ensure a higher level of health and well-being for the population, not only through improved access to health care and services but also through an approach that optimally promotes the engagement of the whole patient. Taking into account the patient experience in primary care is crucial to improving and maintaining a healthcare system that meets patients' real needs. Therefore, it seems essential to agree on the best concepts and constructs to use to measure patient experience in primary care in a clinical context, but also to ensure the development of tools with psychometric qualities that can scientifically support clinical interventions and organizational interventions with regard to patient experience in primary care. Our team will conduct a study to reach a consensus among a panel of experts made up of researchers, professionals and patients on a core set of constructs measuring patient experience in primary care using an electronic Delphi.
ContributorsMarie-Eve Poitras, Université de Sherbrooke
Maxime Sasseville, Université Laval
Vanessa T. Vaillancourt, Université de Sherbrooke
Marie-Eve Perron, Université de Sherbrooke
Véronique Lowry, Université de Sherbrooke
Pierre-Henri Roux-Levy, Université de Sherbrooke
Disease Category: Public health
Disease Name:
Age Range: 18 - 99
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Patient/ support group representatives
- Policy makers
- Researchers
- Service providers
- COS (Other)
- Delphi process
- Semi structured discussion
Face validity assessment:
We will conduct a face validity assessment round based on a scoping review using open-ended questions with experts (n = 4) ahead of the consensus rounds to consolidate operational definitions of the constructs making up the patient experience in primary care in Quebec.
Delphi process:
We will use the results of the face validity round aimed at establishing the list of constructs and their respective operational definitions to construct the questionnaire on REDCap for the three rounds. For this study, we will recruit 25 experts in each group (n total = 100) Healthcare professionals working in primary care; Researchers with expertise in patient experience in primary care; Patient partners with experience or knowledge in primary care; Decision-makers with experience or knowledge in primary care) by e-mail, initially using the contacts of the members of the project's research team and then using the snowball method. Respondents will be asked to comment on three criteria: relevance, possibility for a patient to self-assess this item, and importance for the assessment of the patient experience. Consensus on the inclusion of an item will be established by the positive central tendency associated with an interquartile range (IQR) below 1, and the absence of a negative response from more than 5% of the sample.