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Validation and benchmarking of Patient-Reported Experience Measures (PREM) tool for the safety of patients undergoing
Jawahar S K Pillai1,2, Lallu Joseph3, Biswajeevan Sahoo4
1Hospital Administration, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India jawahardr@yahoo.com.
Background:
MRI uses a magnetic field that can harm patients with metallic implants and eliciting details about implants while entering MRI room is essential. Patient-Reported Experience Measure (PREM) tool takes feedback from patients and checks whether staff have enquired about safety parameters while undergoing the diagnostic test, thereby safeguarding the patients against any potential hazards. Objective of study to develop a context-specific PREM tool for MRI safety through constructive feedback from patients METHODOLOGY: Phase 1 expert group was formed and focused group discussions (FGDs) conducted to develop a Standard Operating Procedure (SOP) and the PREM Questionnaire tool. Phase 2 and phase 3, multiphasic study conducted in 15 hospitals, India with good geographical distribution using purposive sampling. Phase 2 consisted of a pilot study using the PREM tool with a sample size of 213 participants, and phase 3 consisted of a field study with 720 participants.
Results:
PREM tool developed with 21 questions based on SOP, findings of FGDs and patient feedback. The internal consistency of the PREM tool was excellent and indicated high reliability and showed that the expert group considered the questions essential. Concerning removing metallic devices before the scan, 100% of participants said yes in the pilot study and 99% in the main study. Lacunae identified in the study included screening using a metal detector, counselling about history of allergy, side effects of contrast agents and claustrophobia, and methods to contact the staff in case of any emergency during the MRI scan. These findings indicate that there is a need to improve safety practices based on feedback from patients using the MRI Safety PREM tool.
Conclusions:
MRI Safety PREM tool was developed and validated as a zero-cost patient safety tool. Study participants accepted the PREM questionnaire as a vital tool for patients undergoing MRI to ensure patient safety and improved quality of care.
Insights
A new MRI Safety Patient-Reported Experience Measure (PREM) tool was developed to gather patient feedback on safety protocols. This zero-cost tool enhances patient safety and quality of care during MRI scans.
Area of Science:
- Radiology and Imaging
- Patient Safety
- Healthcare Quality Improvement
Background:
- Magnetic Resonance Imaging (MRI) poses risks to patients with metallic implants due to strong magnetic fields.
- Ensuring patient safety requires thorough screening for metallic implants before MRI procedures.
- Patient-Reported Experience Measure (PREM) tools can assess the quality of care and identify safety gaps.
Purpose of the Study:
- To develop a context-specific Patient-Reported Experience Measure (PREM) tool for MRI safety.
- To gather constructive patient feedback to improve MRI safety protocols.
- To validate the developed PREM tool for use in clinical settings.
Main Methods:
- Phase 1: Expert group formation and focus group discussions (FGDs) to develop a Standard Operating Procedure (SOP) and the PREM questionnaire.
- Phase 2 & 3: A multiphasic study conducted in 15 hospitals across India.
- Pilot study (n=213) and field study (n=720) using the developed PREM tool.
Main Results:
- A 21-question MRI Safety PREM tool was developed, demonstrating excellent internal consistency and high reliability.
- High participant agreement (99-100%) on removing metallic devices before MRI scans.
- Identified areas for improvement include metal detector screening, allergy counseling, contrast agent side effects, claustrophobia management, and emergency communication.
Conclusions:
- The MRI Safety PREM tool is a validated, zero-cost patient safety instrument.
- The tool was accepted by study participants as vital for ensuring patient safety and enhancing care quality during MRI.
- Patient feedback via the PREM tool highlights the need for enhanced safety practices in MRI environments.
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