8 things you should not do when selecting a prem

By Keith Meadows

DHP Research & Consultancy Ltd

Copyright DHP Research 2012

DESIGNED BY A

COLLEGUE

Use a PREM simply because a colleague has used it before

Developed for other patient groups

Assume it’s

reliable and

valid without

evidence

Not sure what to do with the information

Developed without

patient input

ASSUME IS RELEVANT TO YOUR PATIENT GROUP

8 Things you should NOT do when selecting a PREM www.dhpresearch.com

INTRODUCTION

Measurement of the patient’s experience is a now a

key factor in providing improved health care.

The Patient Experience Network has provided a lot of information

around the measurement of the patient’s experience including the

7-step measurement process. However, what is not discussed is

some of the do’s and don’ts when choosing or using a PREM.

Regretably with the increasing availability of on-line questionnaire

design packages such as SurveyMonkey, this can lead to a plethora

of questionnaires that would fail the most basic questionnaire

design criteria.

Questionnaire design is a complex process to ensure you collect

the right kind of information to enable good decision-making. Also

choosing the right PREM is also something that requires some

thought.

Who are these tips for?

For the healthcare professional, clinician and researcher who relies

on information on patient satisfaction, health and or experience,

the choice and use of a well designed and validated questionnaire

is essential.

How these tips will help you?

By applying the 8 tips described here when selecting the

appropriate PREM together with proper planning, you will have

greater confidence in the quality of information collected.


http://www.institute.nhs.uk/share_and_network/pen/how_to_measure_patient_experience.html



http://www.surveymonkey.com/?utm_source=adwords&utm_medium=ppc&utm_term=survey monkey&utm_network=s&utm_campaign=e&source=SearchNetwork&placement=&cmpid=brand&mkwid=sEANdl8yy&pcrid=27008719076&pmt=e&kw=survey monkey&gclid=COi2yr3Gv7MCFePHtAodSSAA3A

1 8 Things you SHOULD NOT do when selecting a PREM www.dhpresearch.com

Copyright DHP Research. all rights reserved 2012

4

DON’T USE A

PREM JUST BECAUSE

A COLLEAGUE HAS

USED IT BEFORE

WHY? This is a common error and it should not be assumed

because a questionnaire has been used before it will be

appropriate for YOUR particular study.

The questionnaire might for example, not have been

properly developed or it might be looking for experience

that do not fit with you study objectives.



5

DON’TUSE A PREM

JUST BECAUSE IT’S

BEEN DEVELOPED BY

A COLLEGUE

WHY? Developing a PREM requires considerable experience

and knowledge. If you want to collect reliable and

valid information the PREM needs to have been

developed according to clearly defined criteria,

patient input and using established procedures to

ensure satisfactory reliability and validity.

As tempting as it maybe to go for the ‘quick and

dirty’ this will not give you the information you are

looking for.



6

DON’T USE A

PREM THAT HAS BEEN

DEVELOPED WITHOUT

PATIENT INPUT

WHY? PREMS developed without patient input must be viewed

with suspicion. If we want to find out about the patient’s

experiences then we need to ask them.

At the development stage of a PREM it’s essential that

through such techniques as focus groups and in-depth

interviews we really do find out what these experiences

are which can then be incorporated into the

questionnaire.

PREMs developed on the reliance of HCP input alone, are

based on a different perspective from that of the patient

and undoubtedly will lack significant content.



7

DON’T USE A

PREM THAT HAS BEEN

DEVELOPED FOR

DIFFERENT

POPULATION TO

YOURS

WHY? PPREMs developed for a specific patient population will

unlikely be appropriate if your patient group differs in

any significant way from its intended use.

As experiences and their relevance can vary across

patient groups, PREMs can be either generic or specific.

If the PREM is generic then it should have been

developed to be applicable across different patient

groups etc. If on the other hand if the PREM is specific

then it should not be used if the objectives of your

survey or patient demographics etc., differ in anyway.

Examination of the content (face validity) will give an

indication, but again documented evidence of the PREMs

development should be reviewed prior to its use.



8

DON’T ASSUME

THAT THE PREM IS

VALID AND RELIABLE

WITHOUT ANY

EVIDENCE

WHY? The temptation to use an existing PREM is of course

understandable. It saves time and costs and means you

can just go ahead and use it. Well no, not really. With so

many on-line questionnaire design tools available the

risk is that the questionnaire has just simply been drawn

up.

So what’s the evidence you need to convince you you’ve

got a reliable and valid PREM to use?

Here are some basic questions you must ask:

• Has the development of the PREM been documented?

• What was the reason for developing the PREM?

• Was there patient input and if so who were they?

• How were questions developed and were they pre-

tested?



9

DON’T ASSUME

THE PREM WILL GIVE

YOU THE

INFORMATION YOU

WANT

WHY? PPREMs can be developed to measure a range of patient

experiences from the quality of emotional support

provided through to the quality of the food.

To ensure that the selected PREM will provide the

relevant information you will need evidence of the

rationale behind it’s development and whether this fits

with the objectives of your own survey. A properly

developed PREM should have its development fully

documented.

Of course looking at the content will provide you with

some idea (face validity) however, this is not a

guarantee the PREM has content validity that is:

produced with patient input and is a reliable and valid

instrument.



10

DON’T USE THE

NET PROMOTER

SCORE (NPS)

BECAUSE YOU’VE

BEEN TOLD IT’S THE

BEST THING AVAIALBE

WHY? Because there is no “magic question” that can provide

you with an answer to a complex set of circumstances,

perceptions, intentions, and behaviours as one single

score.



11

DON’T USE A

PREM IF YOU ARE NOT

SURE WHAT TO DO

WITH THE

INFORMATION

COLLECTED

WHY? You must have a clearly defined objective as to what and

how you are going to use the information collected prior

to the survey. You will not achieve anything if your

approach is to think that you will decide once you’ve got

the data.

• You must have a clear analysis plan

• Know in advance what questions you need answers to

• Be sure you are asking the questions you need

answering

About DHP Research

We provide a range of consultancy and support to clinical

research teams, the NHS and academia in making key

decisions when using patient reported outcome (PRO)

and experience (PRE) measures. This includes:

Literature reviews and evaluation of existing patient reported outcome (PRO) measures

Qualitative interviews to derive appropriate content for PROs

Write academic scripts

Training in PROs and research methodologies

Development of patient reported outcomes (PRO)measures

Our expertise in the measurement of patient reported

experience includes:

Help in choosing the right measures

Development of PREMs using state-of-the-art methodologies

Interpreting PREM data.

Copyright DHP Research 2012 12

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MORE

DHP Research & Consultancy Ltd

Bloxham Mill Business Centre

Barford Road, Bloxham

Banbury

Oxfordshire

OX15 4FF

UK: +44 (0)1295 724233

www.dhpresearch.com

[email protected]

http://www.dhpresearch.com/

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DHP Research & Consultancy Ltd Bloxham Mill Business Centre, Barford Road, Bloxham, Banbury, Oxfordshire OX15 4FF Tel: +44 (0)1272 4233 Tel: [email protected]

www.dhpresearch.com

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8 things you should not do when selecting a prem