Patients experience of inpatient care for diabetes
Research type
Research Study
Full title
The development and validation of a Patient Reported Experience Measure (PREM) of diabetes inpatient care for people admitted with any condition
IRAS ID
258985
Contact name
Helen Walthall
Contact email
Sponsor organisation
Oxford Brookes University
Clinicaltrials.gov Identifier
AH2018/1292,
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Summary of Research
Diabetes is a common chronic condition that affects up to 3 million people in the UK. The Annual National Diabetes Audit reports the outcomes and care of people with Diabetes in England and Wales. As part of this audit programme, the annual National Diabetes Inpatient Audit reports on the care of people with diabetes during their inpatient stay, and encourages them to participate in a Patient Experience questionnaire. However, this questionnaire was not developed using a recognised method nor has it been developed for inpatients with diabetes. The PICKER Institute has developed a number of Patient Reported Experience Measures (PREMs) using an established method yet there is not one which explores the inpatient experience of people with diabetes. This study will develop and test a new questionnaire which will measure the experience of people with diabetes during their hospital stay.
This questionnaire’s development comprises the following two stages:
Stage 1: interviewing inpatients once discharged about their stay in hospital and their experience of the diabetes care, and using their words we will design a new questionnaire;
Stage two: sending the questionnaire to people with diabetes (n=200) who have been in hospital to gain feedback on whether the questionnaire is appropriate and addresses all areas of inpatient diabetes experiences from the patient's perspective;Summary of Results
It is estimated that 1 in 6 in-patients on general hospital wards have diabetes; given the complexity of management of the condition, the provision of diabetes-appropriate care for an inpatient with diabetes is a priority. Audit data continuously indicate areas of concern in inpatient diabetes care with patients not receiving adequate care and suffering from avoidable complications. There remains a concern that the patient experience of inpatient diabetes care is not being adequately captured and therefore meaningful improvements are hindered.
This project developed a Patient Reported Experience Measure (PREM) of diabetes inpatient care; a PREM is a questionnaire to gather patient’s views of their experience of care and using one has become increasingly important when assessing and improving the quality of care. We followed a rigorous process to develop a tool to adequately measure a patient’s perception of their personal experience. To make sure that the questionnaire items focus on aspects of the care that matter to patients, we interviewed 27 people living with diabetes who recently had an overnight stay in a hospital across four NHS trusts in Thames Valley, about what went well and what could be improved during their stay. We aimed for participants to be representative of people with diabetes in hospitals at any given time.
We then used these narratives to develop the first draft of the questionnaire and asked 10 participants we interviewed to complete it for us when thinking aloud (this process, called ‘cognitive interviewing,’ helped us to determine if the language used was appropriate and if questions and answer options were exhaustive). We then amended the questionnaire and sent it to nine NHS Trusts across England to disseminate among their inpatients with diabetes on discharge; this was to validate the questionnaire and check how it performed with a bigger group of patients. We heard back from 231 participants out of 627 sent invitations (response rate of 36%); we sent out 455 invitation to complete a paper PREM and 202 were returned (44% response rate) and we sent out 172 invitations to complete an online PREM but only 30 were completed (response rate 17.5%). The PREM consists of questions about patients’ experience of diabetes care on admission to hospital, when managing their diabetes, when receiving treatment and care, during mealtimes, and when leaving hospital. Questions about confidence in healthcare staff managing their diabetes are also included. The PREM is going to be promoted to be used to improve patients’ experience of diabetes care when hospitalised.
This project would not exist without the initiative and contributions from Prof. Helen Walthall (who initiated this study as its first CI) and the clinical team from the OUH NHS FT (Drs Rustam Rea, Alistair Lumb and Garry Tan), Maria Buckley, Dr Amy Tallett and researchers from the Picker Institute Europe, Prof. Crispin Jenkins, and the Oxford Brookes University researchers Dr Sarah Mansbridge and Mr Samuel Bond. Thank you to our participants who committed their time and shared their experiences to help with development and improvement of the tool. We would also like to thank the research nurses whose invaluable knowledge of the most appropriate recruitment strategies for our population and commitment to recruit made it possible.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
19/LO/0644
Date of REC Opinion
26 Apr 2019
REC opinion
Favourable Opinion