Development and validation of the Caregiver‐reported Outcome Measure for Emergency care Transitions (COMET) tool

Abstract INTRODUCTION Emergency department (ED) care transitions are particularly challenging for persons living with cognitive impairment (PLWCI) and their care partners. Existing measures overlook care partners' unique experiences. We developed and validated the Caregiver‐reported Outcome Measure for Emergency care Transitions (COMET) tool to assess these transitions. METHODS We enrolled 170 care partners from four EDs in a multiphase process including qualitative interviews, item development, member checking, cognitive debriefing, expert review, and psychometric testing. RESULTS The final 15‐item COMET tool captures understanding of discharge instructions, caregiver burden, and positive aspects of caregiving. It showed feasibility (mean completion time = 5.87 min), excellent internal consistency ( α = 0.89, ω = 0.99), and good test‐retest reliability ( r = 0.85). Factor analysis supported a clear structure, and correlations with the Care Transitions Measure‐3 supported validity. DISCUSSION COMET is a feasible, reliable, and valid tool for evaluating ED care transitions for PLWCI and their care partners.