Esrd cahps instrument development
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ESRD-CAHPS Instrument Development. Patricia Gallagher, PhD Center for Survey Research University of Massachusetts Boston CAHPS Harvard Team. Who is developing the ESRD survey?. CAHPS II grantees from RAND, Harvard, and AIR.

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ESRD-CAHPS Instrument Development

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Esrd cahps instrument development

ESRD-CAHPS Instrument Development

Patricia Gallagher, PhD

Center for Survey Research

University of Massachusetts Boston

CAHPS Harvard Team


Who is developing the esrd survey

Who is developing the ESRD survey?

  • CAHPS II grantees from RAND, Harvard, and AIR.

  • AHRQ and CMS staff participate as team members since this work is being performed via a cooperative agreement.

    • CMS renal professionals have served as technical advisors at every step.


Call for measures

Call for Measures

  • Federal Register “Call for Measures” in August, 2003.

  • Submissions received from 16 sources.

  • More than 700 items reviewed.

  • Criteria for selection included documented instrument/item validity and reliability and additional testing, e.g., field tests and cognitive testing.


Esrd cahps instrument development

In addition, we drew upon other sources to develop an instrument for testing including:

  • an extensive literature review

  • previous experience with CAHPS surveys

  • state of the art scientific evidence


The cahps design principles for survey development

The CAHPS Design Principles for Survey Development

I. Develop survey instruments that are suitable for and allow valid comparisons across a wide range of potential users.


Cahps design principles for survey development

CAHPS Design Principles for Survey Development

II. Focus on assessments of health care experiences for which consumers are the best or only source of information.


Cahps design principles for survey development1

CAHPS Design Principles for Survey Development

III. Focus on information that consumers want and need to know.


Cahps design principles for survey development2

CAHPS Design Principles for Survey Development

IV. Make sure that the data are as accurate and reliable as possible.


Cahps design principles for survey development3

CAHPS Design Principles for Survey Development

V. Develop survey instruments that are inexpensive and easy to use as possible.


Cahps design principles for survey development4

CAHPS Design Principles for Survey Development

VI. Develop survey instruments and reports in concert.


Cahps design principles for survey development5

CAHPS Design Principles for Survey Development

VII. Obtain both reports of specific patient experiences and overall ratings.


Cahps design principles for survey development6

CAHPS Design Principles for Survey Development

VIII. Provide a ‘core’ set of items that apply to all entities fielding the survey, with the option of adding supplemental questions to address specific needs.


Examples of submitted items

Examples of Submitted Items

  • This staff always treats me with a great deal of respect and never “talks down” to me. [Strongly Disagree; Slightly Disagree; Neutral; Slightly Agree; Strongly Agree]

  • How satisfied are you with the respect, dignity and concern shown to you by the technicians?[Very Satisfied; Satisfied; Dissatisfied; Very Dissatisfied]


Examples of proposed esrd cahps items to measure the quality of staff patient interactions

Examples of proposed ESRD-CAHPS items to measure the quality of staff/patient interactions

  • How long have you been on hemodialysis at {NAME OF FACILITY}? [If <3 months, ineligible]

  • In the last 3 months, how often did the dialysis center staff explain things in a way that was easy for you to understand?[Never; Sometimes; Usually; Always]

  • In the last 3 months, how often did the dialysis center staff show respect for what you had to say? [Never; Sometimes; Usually; Always]


Can the esrd cahps survey be combined with existing surveys

Can the ESRD-CAHPS survey be combined with existing surveys?

  • The ESRD-CAHPS instrument is being designed to accommodate items from existing surveys.

  • Testing of an integrated questionnaire will allow facilities to track the trending of data for quality improvement purposes.


Testing of the draft esrd instrument to date

Testing of the draft ESRD Instrument to date

  • Cognitive Testing

  • Instrument revised based on testing


Additional testing of the draft esrd instrument planned

Additional Testing of the Draft ESRD Instrument Planned

  • Another round of Cognitive Interviewing

  • Revise instrument - based on additional testing

  • Pilot Test


Esrd cahps instrument development

Our goal is to develop practical, workable solutions in collaboration with dialysis facilities and others who have an interest in using the ESRD-CAHPS data.


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