Satisfaction of Older Patients With Emergency Department Care: Psychometric Properties and Construct Validity of the Consumer Emergency Care Satisfaction Scale

J Nurs Care Qual. 2023 Jul-Sep;38(3):256-263. doi: 10.1097/NCQ.0000000000000694. Epub 2023 Feb 24.


Background: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales.

Purpose: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care.

Methods: We administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects.

Results: Using several criteria, we improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring.

Conclusion: We addressed several methodological issues with the CECSS and provided recommendations for improvement.