Patient Reported Experience Measures (Prem) Tool For Enhancing Cataract Surgery Safety In Indian Hospitals

This study aimed to develop and validate a PREM tool tailored to the cataract surgery experience in Indian hospitals, focusing on safety, communication, and patient-centered care.

Cataract surgery is among the most common and successful procedures worldwide, yet understanding patient experiences is vital for holistic care. Patient Reported Experience Measures (PREM) provide a structured way to capture perceptions and identify care gaps. While widely used in healthcare, PREM tools are less common in ophthalmology, especially in cataract surgery in India. Expanding their use could enhance patient-centered care, bridging critical gaps in understanding and improving outcomes.

A multicentric, three-phase study was conducted across 16 hospitals in India. In Phase 1, a 14-item questionnaire was developed through expert consultations and focus group discussions, grounded in standard operating procedures for cataract surgery. Phase 2 involved a pilot study with 240 patients to test the tool's clarity and reliability, leading to certain refinements. In Phase 3, a field study with 582 participants assessed the tool's validity and reliability. Statistical analyses, including Kuder-Richardson Formula 20 (KR-20) and Content Validity Index (CVI), were employed to evaluate the tool's internal consistency and relevance.

The final PREM tool demonstrated excellent internal consistency (KR-20 = 0.801) and strong content validity (S-CVI/Ave = 0.982). Responses revealed that 98.1% of participants confirmed adherence to pre-operative safety protocols, and 97.9% reported satisfactory communication about post-operative care. However, gaps were identified in financial counseling and anesthesia-related communication in a small subset of patients.

The PREM tool for cataract surgery safety provides a robust, patient-centered framework for assessing care quality and identifying areas for improvement. Its implementation can enhance patient safety and satisfaction, fostering a culture of continuous quality improvement in ophthalmology practices.