[Rasch] Logit scores

Lee, Wynne WLee at peacehealth.org
Wed Dec 21 06:00:34 EST 2005

Hi, all
I work at PeaceHealth, a health care organization with 6 hospitals and numerous clinics. We routinely used Rasch-based measures of patient satisfaction for several years now, doing what Mike suggested: transforming logits to "zero - 100" scores.  It's a great, logical, rational and easily implemented approach.
However, there's a real challenge with this transformation. Our patient satisfaction scale is very good. Of the 2000-odd patients we survey every 6 months, there are some who report near-perfect scores and some near the bottom, but most most fall somewhere around the middle (as distributions will).  
The challenge with the "zero-100" representation is that many units for which we issue reports now get scores in the 50 - 75 range. Most people in the medical world are highly educated in very competitive environments. They are used to getting very high grades ... typically 90%+. So, receiving patient satisfaction scores of 50-70 feels like failing.  PeaceHealth has tried, over the years, many strategies, metaphors, discussions, images etc to move people away from that feeling.  It also does not reward particular score levels, but rewards improvements in scores over time. That is, shifts from 25 to 28, 45 to 48 or 75 to 85 are equally valued & rewarded.  
Despite those efforts, managers who get the reports often struggle when they hear their unit's score moved to 62.1, up from 58. It still feels like failure or 'barely passing'. That feeling is augmented by having friends at other hospitals that use non-Rasch based commerical patient satisfaction surveys, who often get nice, high scores like 85 or 90!  Competitive urges (and economics) combined with years of conditioning to think that only scores > 80 are really "good" takes a real psychological toll.
Maybe this is just a problem for health care organizations.  Has anyone else run into this challenge? Found a work-around?


Wynne A. Lee, Ph.D. 
Data Analyst, Survey Team 
HID Continuous Improvement Division, PeaceHealth 
Bellingham, WA  98225-1898 
Tel. (360) 738-6300 X4581 
Email:  < mailto:wlee at peacehealth.org> 
There can be no happiness if the things we believe in are different from the things we do.            Freya Stark 

  -----Original Message-----
From: rasch-bounces at acer.edu.au [mailto:rasch-bounces at acer.edu.au]On Behalf Of Mike Linacre (RMT)
Sent: Monday, December 19, 2005 8:46 AM
To: Rama Guinda; rasch at acer.edu.au
Subject: Re: [Rasch] Logit scores

Dear Rama:

How about linearly transforming logits into the range 0-100 for the lowest to highest possible measure on the test? Then the Rasch measures mean "per cent of the way up the test".

What transformations have other folks found useful?

Mike L.

Rama Guinda wrote:

How to report the logit scores in the form of understandable and meaningful scores for the students, parents and teachers?
Scores that are easy to make sense of and at the same time maintain the interval characteristic of the logit scores.

Mike Linacre
Editor, Rasch Measurement Transactions
rmt at rasch.org  <http://www.rasch.org/rmt/> www.rasch.org/rmt/ Latest RMT: 19:3 Winter

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