Community-Defined Priorities for an Indigenous Patient Experience Feedback Tool: A Mixed-Methods Study of Stakeholder Assessments of Feasibility and Actionability.

IntroductionThe Validating Outcomes by Including Consumer Experience (VOICE) Project is working with Indigenous Australian communities and health services to co-design a Patient Reported Experience Measure (PREM), to be used for continuous quality improvement (CQI) and service accreditation. Early project processes identified four themes important to communities' care experiences: (1) accessing quality care, (2) owning the space, (3) knowing is important, and (4) working with people as partners in their healthcare. This study engaged Indigenous community and advisory group members, and other Indigenous primary health care stakeholders in prioritising PREM topics within each theme.MethodsIndigenous researchers led this mixed-methods study through three phases: (1) voting by community members to prioritise topics; (2) a health stakeholder online survey to assess relevance, usefulness and practicality of the community-prioritised topics for improving care quality; and 3) review against prespecified criteria for item reduction. Recommendations were presented to the Advisory Group for guidance to shortlist topics for the next phase, cognitive testing of the PREM questions.ResultsCommunity participants prioritised 38 (from 69) topics, which were confirmed through the online survey. A majority agreed that services have power to control/influence all but two topics. The stakeholder-rated topics assessed against the criteria for item reduction identified 39 consolidated items relevant to two versions of the PREM, 'episode of care', and 'periodic' versions.ConclusionsThe consolidation process resulted in 39 important topics for inclusion in the PREM. Many of the topics identified are not currently considered when collecting PREM data. Addressing these topics would likely improve the quality and relevance of data collected for accreditation requirements, CQI, program evaluation, reporting, and policy development.