Development of a survey instrument assessing staff and patient perceptions of comprehensive rehabilitation programs

A survey instrument was developed and administered to two rehabilitation hospitals. The instrument assesses staff and patient perceptions of the quality of services, the environmental quality, psychosocial climate and the perceptions of what is important in the rehabilitation process. The responses of the various staff groups, patients, and nontreatment groups were analyzed separately. The study consisted of the following phases: 1. Development of the instrument through consultation with hospital personnel and ex-patients. 2. Administration of the instrument to staff and patients at two hospitals, including a retest of a subsample one month later. 3. Factor analysis of the results to create factor scales and scoring of the data on these scales. 4. Analysis of variance of the scale scores between response groups (nursing, physical therapy, patients, etc.), between supervisory and treatment personnel and on the basis of respondent age and length of time employed at the hospital. 5. Cluster analysis of respondents using factor scores from a second-level factor analysis of the scale scores. Comparison of cluster composition with response groups. 6. Test/retest analysis of factor scale scores. 7. Feedback of results to the hospital community through a series of departmental presentations. 8. Recommendations for a more efficient second generation instrument. The results indicate adequate levels of reliability and validity. The instrument discriminated between the two hospitals, between staff and patients, and between treatment staff and nontreatment personnel. Staff employed less than a year differed from those employed more than a year. Few differences were found between supervisory and treatment personnel or between staff of different ages. Recommendations are made for the use of the instrument in monitoring hospital operation and assessing program changes. A model of clinical program evaluation is presented to provide a framework within which the results might be used to improve communication within the hospital community or stimulate discussion of program goals and policies.