Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT).

Objective To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT. Background Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used. Methods CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility. Results CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28–0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact. Conclusions CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.

A critical analysis of e-government evaluation models at national and local municipal levels

Abstract: The importance of e-government models lies in their offering a basis to measure and guide e-government. There is still no agreement on how to assess a government online. Most of the e-government models are not based on research, nor are they validated. In most countries, e-government has not reached higher stages of growth. Several scholars have shown a confusing picture of e-government. What is lacking is an in-depth analysis of e-government models. Responding to the need for such an analysis, this study identifies the strengths and weaknesses of major national and local e-government evaluation models. The common limitations of most models are focusing on the government and not the citizen, missing qualitative measures, constructing the e-equivalent of a bureaucratic administration, and defining general criteria without sufficient validations. In addition, this study has found that the metrics defined for national e-government are not suitable for municipalities, and most of the existing studies have focused on national e-governments even though local ones are closer to citizens. There is a need for developing a good theoretical model for both national and local municipal e-government.