Assessing Patients' Experiences with Medical Injury Reconciliation Processes: Item Generation for a Novel Survey Questionnaire.

Abstract Background Many health care organizations want to improve their responses to patients who suffer medical injuries. Their ability to understand how well they meet patients’ needs is limited by the lack of suitable instruments for assessing injured patients’ experiences. Methods We aimed to generate items for a patient experience questionnaire that medical facilities can use to assess how well resolution met patients’ needs. We designed the Medical Injury Reconciliation Experiences Survey (MIRES) based on findings from previous studies of New Zealand and American patients’ experiences of non-litigation resolution of medical injuries. We performed a content analysis of 24 transcripts from a stratified random sample of 92 interviews from the prior studies. We extracted themes to develop a draft questionnaire. We revised the questionnaire following feedback from experts. We conducted cognitive debriefing interviews with 24 New Zealand and American injured patients. Results There were 40 items in the following domains: perceptions of communications with health care providers after the injury (15 items); perceptions of remedial gestures (11 items); indicia of the patient's overall satisfaction with the reconciliation process (4 items); the nature and impacts of the injury (5 items); and patients’ characteristics (5 items). Participants’ feedback about the questionnaire was predominantly positive. Their suggestions led to 37 revisions. Conclusion The MIRES was comprehensible and acceptable to this group of post-injury patients. While further testing is desirable, the MIRES offers promise as a practicable approach that health care organizations can use to assess how well their reconciliation processes met patients’ needs.