ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2026
Development and Validation of the Emergency Department Transitions Measure.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Development and Validation of the Emergency Department Transitions Measure.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.
methodsThis mixed methods study was conducted across a large healthcare system in three phases: item generation, cognitive interviewing, and large-scale validation. Scale items were generated by experts and then iteratively refined using feedback from cognitive interviews (n = 11). The measure was then validated on a large sample of patients (n = 301) recently discharged from the ED. Exploratory structural equation modeling (ESEM) was employed to assess factor structure. Bivariate correlations were used to assess discriminant and convergent validity using the Care Transition Measure (CTM-3) and the Communication Assessment Tool-Teams (CAT-T).
resultsThe measure was iteratively refined by way of an expert panel and cognitive interviews which resulted in a 15-item measure to be used for validation. The validation sample (n = 301) was 62% women, 49% White, and the majority having Medicare and/or Medicaid (68%). Sequential comparisons between confirmatory factor analyses and ESEM resulted in a final 10-item two-factor structure. Reliability was excellent (0.93), and bivariate correlations indicated positive correlations between the EDT, CTM-3, and CAT-T.
conclusionThe EDT measure demonstrates content validity, structural validity, convergent validity, discriminant validity, and high internal consistency (i.e., reliability). This newly developed patient reported outcome measure can be used in future clinical and research work to better understand the impact of ED interventions on quality-of-care transitions for patients with diagnostic uncertainty.
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