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Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT)

Beattie, Michelle; Shepherd, Ashley; Lauder, William; Atherton, Iain; Cowie, Julie; Murphy, Douglas J


Michelle Beattie

Ashley Shepherd

William Lauder

Julie Cowie

Douglas J Murphy


Objective To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT.

Background Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used.

Methods CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility.

Results CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28–0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact.

Conclusions CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.

Journal Article Type Article
Acceptance Date Apr 26, 2016
Online Publication Date Jun 14, 2016
Publication Date Jun 14, 2016
Deposit Date Jun 28, 2016
Publicly Available Date Jun 28, 2016
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 6
Issue 6
Article Number e010101
Keywords CEFIT; development; measure; patient experience;
Public URL
Publisher URL
Contract Date Jun 28, 2016


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