Aims and Objectives Measurement of acute care quality and effectiveness is usually constrained to service metrics such as mortality and waiting times. Meaningful measurement for older people living with frailty would include additional person-centred outcomes of healthcare knowledge, shared decision-making, and situational security. Consideration of these requires patient-reported outcome measures (PROMs), which are useful at the system level (commissioning), service level (quality improvement), and patient level (goal elicitation). We have previously reported the development and field-testing of a PROM for older people living with frailty receiving acute care – the PROM-OPAC. This study examined PROM-OPAC for feasibility, reliability, and validity.

Method and Design Older people living with frailty and receiving acute healthcare were recruited at three UK hospitals. They completed the PROM-OPAC and concurrent measures totalling 16 items. Data were analysed for feasibility (completeness, completion time), reliability (response distribution, internal consistency), and validity (confirmatory factor analysis, hypothesis testing).

Results and Conclusion 66 participants completed the final draft PROM-OPAC. 98% responses were complete and median completion time was 11 (IQR: 12) minutes. Responses were adequately distributed without end-effects and internal consistency was acceptable (Cronbach’s alpha: 0.71). Eight items had acceptable fit on two factors for self-determination and security (RMSEA: 0.065; TLI: 0.917; CFI: 0.944) and as hypothesised these responses were lower when respondents had longer waiting times or required hospital admission.

Administration of PROMs for research in emergency care settings was feasible with older people living with frailty; implementation for clinical applications requires further evaluation. The eight-item PROM-OPAC considers outcome goals specific to this population and was observed here to have metric reliability and validity.