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Patient Experience Questionnaire (PEQ)

See the PEQ: Link to the measure within the original published paper (pages 417-418)

The PEQ (Steine, Finset & Laerum, 2001) is a free to use, reliable, validated measure of patient experience. It is an 18 item self-reported measure of how a patient has felt about their consultation. It should be used only in one-on-one consultation circumstances. It was developed on a sample of outpatients. The items are not all suitable to domiciliary consultations. If you work in an inpatient setting the PPE-15 *link* is probably more suitable: It measures patient experience along the domains: communication; emotions; short-term outcomes; barriers; and relations with auxiliary staff. The PEQ can be used to gain feedback on the practitioner-patient relationship across these domains. While it was developed for use by doctors, the questions are generic enough that it could be easily adapted to be used by other health professionals (e.g., change occurrences of the word ‘doctor’ to ‘practitioner’). It can be used with children and with individuals with cognitive or communication difficulties (use your clinical judgement to assess suitability with such patients). It can be completed by a parent, carer or guardian. Patients can complete the measure either in their own time or following the consultation. Ideally (to obtain the truest responses) patients should not complete this with the health professional. Because patients can complete this in their own time, clinic time should have minimum disruption. No reported average length of time for completion could be obtained (other than ‘a few minutes’), but it is likely to take patients around 10 minutes to complete.

How to collect the data
The PEQ should be given to your patient at the end of their outpatient consultation. Do not self-select the patients; even those patients who you feel may not have had the best experience should be given the opportunity to feedback. It is best to give these out to consecutive patients until you have reached your target number of completed questionnaires. You should hand the PEQ to your patient and either:

  • Ask them to complete it in the waiting area or reception before they leave the clinic. If doing this provide a drop-box or dedicated, clearly labelled area that they can place their completed forms in. This is the better option to ensure a good return rate (to ensure that most of the questionnaires are returned).
  • Ask the patient to complete the PEQ at home and return it to you. Including stamped addressed envelopes for returning the questionnaire will increase your return rate but will also add an additional cost.

You can also include a covering letter explaining why you are asking them to complete the PEQ (e.g., that you are interested in learning from their experience of care and would use the information to improve future service, or similar). This may improve completion rates for those who take the questionnaire home.

How much data do you need to collect?
The PEQ uses a simple scoring system that is explained below. Because it is a relatively simple and flexible measure of patient experience, no minimum number of patient responses has been recommended by the authors. However, as with all patient surveys or research projects, you should aim to collect a reasonable number of questionnaires from a representative sample of your patients. The larger number of patents you have complete the PEQ, the better and more meaningful your feedback will be about your service.

What to do with your raw data – scoring the measure
The first 14 questions on the PEQ are scored on a 1-5 tick-box response scale. The last four questions are scored on a visual analogue scale rated from 1 to 7. See pages 416-417 of this paper to get a better idea of how this looks.

The questionnaire is broken into sections for you (Outcome, Communication experiences, Communication Barriers, Experience with auxiliary staff, Emotions). For each of these five sections you should sum each patient’s responses, and then work out the mean average for that section/factor. The summing scale (the numbers that you should add per response) are shown on the questionnaire linked above.

As an example, if a patient responds ‘agree completely’ and ‘disagree’ to questions 13 and 14, respectively, you would add up the corresponding values given in the linked questionnaire, then dividing this number by the total number of questions in that section/factor. In this case: 

  • 1 (for agree) + 4 (for disagree) = 5
  • You would then divide this number by two, because there are two questions in this section. This gives you a score of 2.5 (5 divided by 2) for the factor ‘Experiences with auxiliary staff’.

When you are doing this for a large number of questionnaires you may wish to set up an MS Excel spreadsheet (or similar) to automatically sum and average the scores per section for you.

Do this for each of the five sections of the questionnaire. It is helpful to graph the final scores for the sections/factors and the raw scores to the questions to give you an easily interpreted idea of the spread of the responses.

Interpreting your findings
The general rules to interpretation are as follows:

  • For each of the five scales, a high score represents a better outcome so a high score represents
    • A good communication experience
    • Positive emotions
    • Positive consultation outcome
    • No communication barriers
    • Good relations with the staff
  • The details of and possible range of scores on the five scales are as follows
    • Communication scale (questions 5-8; range 1-5; mid-point 2.5)
    • Emotion scale (questions 15-18; range 1-7; mid-point 3.5)
    • Outcome scale (questions 1-4; range 1-5; mid-point 2.5)
    • Barriers scale (questions 9-12; range 1-5; mid-point 2.5)
    • Auxiliary staff scale (questions 13-14; range 1-5; mid-point 2.5)

To our knowledge no table of normative values exist for the PEQ, so we cannot suggest cut off scores on which to judge how you have done. However, the original testing of the PEQ found the following average scores per scale (you can choose to use these as a guide or a baseline to compare your own scores with if you wish):

  • Communication scale (mean 4.6; median 5)
  • Emotion scale (mean 5; median 5)
  • Outcome scale (mean 2.9; median 3)
  • Barriers scale (mean 1.6; median 1.5)
  • Auxiliary staff scale (mean 4.2; median 4.5)

The logical scoring of the questionnaire allows you to identify where there are problems. If you have a score that is below the mid-point on a particular scale, then this would indicate that you have a problem with that element of the patient experience- you would need to make an improvement plan to address the problem. On the other hand, if your scores are high (above the mid-point) on the scales then you can take this as a good indicator that you do not have a problem with those elements of the patient experience.

As previosuly mentioned, putting your responses into graphs (a bar graph would be best) will help you to visualise where the problems are and what areas of service need to be improved. You should plot out bars for the sum/average score per scale to give you an idea of how your service is across the five scales. It is also helpful to graph the proportion of responses to each of the 1-5 or 1-7 options per scale (see page 414 of this paper for an example of this). This will let you know not only your overall score but also the spread of your scores, which can be useful to get a picture of how patients have rated their overall experiences.

To keep track of any changes that you have made to service and how this may have altered the patient experience, you should keep records of your findings. This will allow you to demonstrate the impact of your practice over time and identify trends.

Reporting your findings
See also Stage 5: Reporting Outcomes

For the PEQ we recommend that you graph the responses to the five scales to give an immediate visualisation of the spread of your data. This will allow you and other staff or managers to immediately grasp the areas where improvement is required. You should graph the percentages of your responses to each option, and report on the mean average value (this is your key value to help you interpret your data). This will allow you to compare results from different time periods.

After each of your five graphs you should comment on your findings too. Spell out to your reader what the key message in the graph is. Do this concisely and make some conclusions. To make the reporting of information easier for you we suggest that you use the following template to report your findings. This is not the whole story, however, just a small part of it. You should still continue on to Stages 5 and 6 to best report your findings and to move onto the next stages (e.g., acting on your findings).

Patient experience was measured using the Patient Experience Questionnaire (PEQ). This questionnaire highlights any issues that the patient has experienced with their individual outpatient consultation. The findings to each of the questions are graphed below for ease of reading. A higher score represents a positive experience and a lower score represents a poorer experience

_*put graphs in for each of the five scales – don’t make them too large or too colourful, the easier to see the better*_

Underneath each graph: As shown in the graph the majority of patients responded ‘positively(if a high score)/negatively(if a low score)’ on the scale ‘_*put scale name here*_’. The mean average score for this scale was __. This indicates that there is/is not a problem with this element of the patient experience as it is higher/lower than the neutral mid-point value of 2.5/3.5 for this scale.

If there is not a problem: As no problem in this aspect of patient experience is reported we will continue to deliver high levels of patient care in this area.

If there is a problem: In order to address this issue, the following actions will be taken. _*Describe improvement plan*_.

If you have collected data using the PEQ before: The finding in the graph above shows that this element of the patient experience has improved/declined since our last measurement on _*date of last survey*_. We will continue to strive to improve the service based on these findings.

Relevant Publications
Steine, S., Finset, A., & Laerum, E. (2001). A new, brief questionnaire (PEQ) developed in primary care for measuring patients’ experience of health interaction, emotion and consultation outcome. Family Practice, 18(4), 410-417.

Relevant links
Information on improving patient experience

Copyright/Intellectual property rights
See: Steine, S., Finset, A., & Laerum, E. (2001). A new, brief questionnaire (PEQ) developed in primary care for measuring patients’ experience of health interaction, emotion and consultation outcome. Family Practice, 18(4), 410-417.

You have reached the end of the guidance for this measure.  Move onto Stage 5: Reporting Outcomes.

Or go back to Stage 3: Considering Options to review other measures.


© Copyright 2012 NMAHP RU, Stirling University