Development and validation of the Caregiver-reported Outcome Measure for Emergency care Transitions (COMET) tool.

INTRODUCTION

Emergency department (ED) care transitions are particularly challenging for persons living with cognitive impairment (PLWCI) and their care partners. Existing measures overlook care partners' unique experiences. We developed and validated the Caregiver-reported Outcome Measure for Emergency care Transitions (COMET) tool to assess these transitions.

METHODS

We enrolled 170 care partners from four EDs in a multiphase process including qualitative interviews, item development, member checking, cognitive debriefing, expert review, and psychometric testing.

RESULTS

The final 15-item COMET tool captures understanding of discharge instructions, caregiver burden, and positive aspects of caregiving. It showed feasibility (mean completion time = 5.87 min), excellent internal consistency (α = 0.89, ω = 0.99), and good test-retest reliability (r = 0.85). Factor analysis supported a clear structure, and correlations with the Care Transitions Measure-3 supported validity.

DISCUSSION: COMET is a feasible, reliable, and valid tool for evaluating ED care transitions for PLWCI and their care partners.