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Instruments to measure patient experience of health care quality in hospitals: a systematic review protocol

Beattie, Michelle; Lauder, William; Atherton, Iain; Murphy, Douglas J


Michelle Beattie

William Lauder

Douglas J Murphy


Improving and sustaining the quality of care in hospitals is an intractable and persistent challenge. The patients’ experience of the quality of hospital care can provide insightful feedback to enable clinical teams to direct quality improvement efforts in areas where they are most needed. Yet, patient experience is often marginalised in favour of aspects of care that are easier to quantify (for example, waiting time). Attempts to measure patient experience have been hindered by a proliferation of instruments using various outcome measures with varying degrees of psychometric development and testing.


We will conduct a systematic review and utility critique of instruments used to measure patient experience of health care quality in hospitals. The databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (Psych Info) and Web of Knowledge will be searched from inception until end November 2013. Search strategies will include the key words; patient, adult, hospital, secondary care, questionnaires, instruments, health care surveys, experience, satisfaction and patient opinion in various combinations. We will contact experts in the field of measuring patient experience and scrutinise all secondary references. A reviewer will apply an inclusion criteria scale to all titles and abstracts. A second reviewer will apply the inclusion criteria scale to a random 10% selection. Two reviewers will independently evaluate the methodological rigour of the testing of the instruments using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Disagreements will be resolved through consensus. Instruments will be critiqued and grouped using van der Vleuten’s utility index. We will present a narrative synthesis on the utility of all instruments and make recommendations for instrument selection in practice.


This systematic review of the utility of instruments to measure patient experience of hospital quality care will aid clinicians, managers and policy makers to select an instrument fit for purpose. Importantly, appropriate instrument selection will provide a mechanism for patients’ voices to be heard on the quality of care they receive in hospitals.

Journal Article Type Article
Acceptance Date Dec 13, 2013
Online Publication Date Jan 4, 2014
Publication Date 2014-01
Deposit Date Feb 11, 2015
Publicly Available Date Feb 11, 2015
Journal Systematic Reviews
Print ISSN 2046-4053
Electronic ISSN 2046-4053
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 3
Article Number 4
Keywords Health care; patient care; quality; medical services; hospitals; management; analysis
Public URL
Publisher URL
Contract Date Feb 11, 2015


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