Development and Validation of WeCares, a Survey Instrument to Assess Hospitalized Patients’ and Family Members’ “Willingness to Engage in Your Care and Safety”

Abstract Background Patient engagement is recognized as a method to improve care quality and safety. We developed WeCares (Willingness to Engage in your Care and Safety), a survey instrument assessing patients’ and families’ engagement in the safety of their care during their hospital stay. The objective of the study is to establish the preliminary construct validity and internal consistency of WeCares. Methods We distributed WeCares to patients and families. With the survey responses, we performed exploratory factor analysis (EFA) to identify the factorial structure of WeCares. The internal consistency was assessed using Cronbach's alpha. We also performed descriptive and comparative analysis to summarize patients’ and families’ responses. Results A total of 247 patients and families responded the WeCare survey, of which 224 were used for EFA. EFA resulted in a 13-item, four-factor structure, including: (1) comfortable sharing concerns, (2) responsibility for preventing errors, (3) perception of care team members’ attitude, and (4) patients’/families’ role in preventing errors. The Cronbach alphas were .716 - .866, indicating acceptable internal consistency. Overall, patients and families were comfortable sharing concerns with clinicians but preferred to remain anonymous. They felt the care team members hold most responsibility for error prevention, however, and agreed on their ability to help prevent errors. Conclusions We developed WeCares to assess patients’ and families’ willingness to engage. WeCares can also be used to facilitate conversation about safety concerns and shared responsibility. We believe this would lead to patient activation in guarding their own care and ultimately improve patient outcomes and safety.