Background: Patient experience is a core domain of healthcare quality, closely linked to safety, effectiveness, and readmission outcomes.1-5 Yet, hospital medicine units often rely on delayed, post-discharge surveys such as Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that limit timely and meaningful improvement and lack unit-level insights.6-9 These instruments suffer from recall/response bias, low response rates, and delayed feedback that hinder real-time service recovery.10Real-time patient-reported experience measures (PREMs) offer a promising alternative to post-discharge surveys by capturing feedback repeatedly during hospitalization, facilitating immediate response to concerns and fostering continuous quality improvement.11-13 However, validated tools for real-time inpatient use remain limited and their integration into routine hospital workflows has not been systematically evaluated. In this ongoing pilot, we evaluated the feasibility of using the consideRATE questions, a validated patient and care-partner-reported measure of serious illness care experience, as a real-time PREM.1–5
Methods: On two hospital medicine units, nursing students administered consideRATE and brief feasibility questions to hospitalized adults weekly. Medically stable English-speaking adults on hospital day 2-21, with capacity to participate were eligible. We collected feasibility and process measures and administered a self-developed acceptability survey. Forthcoming is administration of Weiner’s three validated implementation measures to nursing teams.
Results: We screened 94 patients, representing 57%, and 37% (n = 35) were eligible for inclusion. Of those, 96% (n = 23) agreed to fill out the survey, with 77% completing at least one item. Estimated median administration time was 10 minutes, and 100% of surveys were reviewed for service recovery opportunities same-day. The mean ease of completion score was 88/100, with 100 representing “definitely yes.” Similarly, we found a mean score of 97 for comfort with sharing via the tool, 88 for worthwhileness, and 93 for recommending continued use. Preliminary scores were a mean of 91.4 and top-box (all “very good” responses across questions) of 59.3%. Highest ratings in respect domain (80% top box). No workflow disruptions or adverse events were reported, and one flagged “very bad” score in the communication domain was reported and escalated to leadership within 24 hours for real-time service recovery.6
Conclusions: This pilot will provide insight into whether the consideRATE questions are a feasible real-time PREM and service-recovery mechanism for hospital medicine.