This document summarizes a study that implemented a patient experience evaluation tool called the WatLXTM across 24 ambulatory rehabilitative care sites in Ontario involving 968 patients. The tool was found to be both valid and reliable for measuring patient experience. Key factors that contributed to the successful implementation included providing training webinars, developing relationships between stakeholders, clear communication, and Ontario's culture of focusing on patient experience. Future research will examine digitizing the survey to address resource and data entry challenges.

1. Lessons from the field: A province-wide implementation of the WatLX™, a patient
experience instrument for rehabilitative care
Josephine McMurray1, PhD, Heather McNeil1, PhD, Jacobi Elliott2, PhD, Alicia Gordon2, BSc (Cand.), Rebecca Ho3, MASc, MHSc,
Charissa Levy3, MHSc, BScOT, OT Reg (Ont), Paul Stolee2, PhD
1. Wilfrid Laurier University - 73 George St Brantford, Ontario, N3T3Y3 Canada 2. University of Waterloo 3. Rehabilitative Care Alliance
Email: jmcmurray@wlu.ca Website: https://www.drive-health-ecosystems.com/
• There is growing interest in the measurement of patient experience for
service quality improvement.
• Patients in rehab care are medically complex & interact with many care
providers across system.
• Their condition and treatment may produce differences in their
conceptualization of an optimal experience while receiving care.
• Researchers have worked with providers, patients, and decision makers to
develop a valid and reliable instrument that measures rehabilitative care
patients’ experience across the care continuum.
• We report on the implementation of the province-wide pilot of WatLX™, a
patient experience evaluation tool for rehabilitative care.
Background & Objectives Methods
• Following a systematic review, a parsimonious measure named the
WatLX™ was created and evaluated for content and face validity.
• Cognitive interviewing (Willis, 2015) tested usability, and feasibility and
reliability testing was conducted in three ambulatory care settings in
southwestern Ontario; the process of developing that instrument is
available in two papers published in the Archives of Physical Medicine and
Rehabilitation (McMurray et al., 2015a, 2015b).
• The WatLX™ was used for a provincial proof of concept study at multiple
ambulatory rehabilitative care sites (n=24) involving a broadly
representative sample of patients (n=968) by age, gender and primary
condition.
Results
This provincial pilot proof of concept project used the WatLX™ tool to gather patient experience data from participants receiving rehabilitative care in a variety of ambulatory
care settings. The results of the study suggest that the WatLX™ is both valid (Pearson’s: 0.732) and reliable. The characteristics of the patient, condition for which they were
receiving care, and grouping by age, gender, and care setting required adjustments to the WatLX™ survey administration and data collection protocol, however its
implementation minimally impacted workflow. Feasibility, as measured by item completion rate, was high. Use of training webinars, the development of a relationship
between stakeholders, clear communication, and a provincial culture in healthcare of a greater focus on the patient experience helped to ensure the success of the pilot
study.
We found a good internal consistency, measured with Cronbach’s alpha- 0.906.
Reliable instruments ensure accurate measurement of phenomena, however complementary elements such as effective protocols, and staff training were found to be crucial to
the success of this multi-site study. Future research will examine the digitization of the survey to address resource constraints, and data entry challenges.
Conclusions
Key factors for successful implementation
• Use of training webinars
• Development of a relationship between stakeholders
• Clear communication
• Provincial culture in healthcare of a greater focus on the patient
experience