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16-03-2023

How to make PROMs work: qualitative insights from leaders at United States hospitals with successful PROMs programs

Gepubliceerd in: Quality of Life Research | Uitgave 8/2023

Abstract

Purpose

Elucidate facilitators, barriers, and key lessons learned regarding the implementation of system-wide clinical patient-reported outcome measure (PROM) programs among United States (US) healthcare leaders.

Methods

We conducted semi-structured interviews with 35 US healthcare leaders, including chief-level executives, data directors, PROM directors, and department chairs involved in PROM implementation across seven diverse healthcare systems from February to June 2020. Transcripts were coded, evaluated for qualitative themes, and categorized according to the consolidated framework for implementation research (CFIR).

Results

According to US hospital leaders with experience in existing clinical PROM programs, there are facilitators and barriers to implementation success in each CFIR domain. Allowing clinicians to select PROM measures and ensuring a user-friendly data platform (intervention); adapting data collection to patient home environments (outer setting); informing clinicians of the multi-faceted use of PROM data for research, clinical care, and business (inner setting); implementing PROM education earlier into clinician training (characteristics of individuals); and establishing specialty-agnostic PROM implementation teams (process) were among key facilitators to implementation success.

Conclusion

Leaders of geographically and clinically diverse PROM programs in the US identify common themes that facilitate successful implementation. Drivers of success depend on factors within and outside the clinical environment. These findings may serve to guide both establishing new PROM programs and refining existing PROM programs.

vorige artikel Exploring what matters to residents of Australian aged care facilities with the Happy Life Index: comparison of qualitative responses between pre- and mid-Covid-19 pandemic time points

volgende artikel Quality of life and psychological distress of patients with advanced cancer in the Philippines

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Marshall, S., Haywood, K., & Fitzpatrick, R. (2006). Impact of patient-reported outcome measures on routine practice: A structured review. Journal of Evaluation in Clinical Practice, 12(5), 559–568. https://doi.org/10.1111/j.1365-2753.2006.00650.xCrossRefPubMed

Lavallee, D. C., Chenok, K. E., Love, R. M., Petersen, C., Holve, E., Segal, C. D., & Franklin, P. D. (2016). Incorporating patient-reported outcomes into health care to engage patients and enhance care. Health Affairs (Project Hope), 35(4), 575–582. https://doi.org/10.1377/hlthaff.2015.1362CrossRefPubMed

Refolo, P., Minacori, R., Mele, V., Sacchini, D., & Spagnolo, A. G. (2012). Patient-reported outcomes (PROs): The significance of using humanistic measures in clinical trial and clinical practice. European Review for Medical and Pharmacological Sciences, 16(10), 1319–1323.PubMed

Boyce, M. B., & Browne, J. P. (2013). Does providing feedback on patient-reported outcomes to healthcare professionals result in better outcomes for patients? A systematic review. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 22(9), 2265–2278. https://doi.org/10.1007/s11136-013-0390-0CrossRefPubMed

Kotronoulas, G., Kearney, N., Maguire, R., Harrow, A., Di Domenico, D., Croy, S., & MacGillivray, S. (2014). What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 32(14), 1480–1501. https://doi.org/10.1200/JCO.2013.53.5948CrossRefPubMed

Gibbons, C., Porter, I., Gonçalves-Bradley, D. C., Stoilov, S., Ricci-Cabello, I., Tsangaris, E., Gangannagaripalli, J., Davey, A., Gibbons, E. J., Kotzeva, A., Evans, J., van der Wees, P. J., Kontopantelis, E., Greenhalgh, J., Bower, P., Alonso, J., & Valderas, J. M. (2021). Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD011589.pub2CrossRefPubMedPubMedCentral

Sisodia, R. C., Dewdney, S. B., Fader, A. N., Wethington, S. L., Melamed, A., Von Gruenigen, V. E., Zivanovic, O., Carter, J., Cohn, D. E., Huh, W., Wenzel, L., Doll, K., Cella, D., & Dowdy, S. C. (2020). Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, part I. Gynecologic Oncology, 158(1), 194–200. https://doi.org/10.1016/j.ygyno.2020.04.696CrossRefPubMedPubMedCentral

Squitieri, L., Bozic, K. J., & Pusic, A. L. (2017). The role of patient-reported outcome measures in value-based payment reform. Value in Health : The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 20(6), 834–836. https://doi.org/10.1016/j.jval.2017.02.003CrossRefPubMed

Hildon, Z., Neuburger, J., Allwood, D., van der Meulen, J., & Black, N. (2012). Clinicians’ and patients’ views of metrics of change derived from patient reported outcome measures (PROMs) for comparing providers’ performance of surgery. BMC Health Services Research, 12, 171. https://doi.org/10.1186/1472-6963-12-171CrossRefPubMedPubMedCentral

10.

Basch, E. (2017). Patient-reported outcomes–harnessing patients’ voices to improve clinical care. The New England Journal of Medicine, 376(2), 105–108. https://doi.org/10.1056/NEJMp1611252CrossRefPubMed

11.

Snyder, C. F., Aaronson, N. K., Choucair, A. K., Elliott, T. E., Greenhalgh, J., Halyard, M. Y., Hess, R., Miller, D. M., Reeve, B. B., & Santana, M. (2012). Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 21(8), 1305–1314. https://doi.org/10.1007/s11136-011-0054-xCrossRefPubMed

12.

Zhang, B., Lloyd, W., Jahanzeb, M., & Hassett, M. J. (2018). Use of patient-reported outcome measures in quality oncology practice initiative-registered practices: Results of a national survey. Journal of Oncology Practice, 14(10), e602–e611. https://doi.org/10.1200/JOP.18.00088CrossRefPubMed

13.

Philpot, L. M., Barnes, S. A., Brown, R. M., Austin, J. A., James, C. S., Stanford, R. H., & Ebbert, J. O. (2018). Barriers and benefits to the use of patient-reported outcome measures in routine clinical care: A qualitative study. American Journal of Medical Quality : The Official Journal of the American College of Medical Quality, 33(4), 359–364. https://doi.org/10.1177/1062860617745986CrossRefPubMed

14.

Mou, D., Sisodia, R. C., Castillo-Angeles, M., Ladin, K., Bergmark, R. W., Pusic, A. L., Del Carmen, M. G., & Heng, M. (2022). The surgeon’s perceived value of patient-reported outcome measures (PROMs): An exploratory qualitative study of 5 different surgical subspecialties. Annals of Surgery, 275(3), 500–505. https://doi.org/10.1097/SLA.0000000000004253CrossRefPubMed

15.

Montgomery, N., Howell, D., Ismail, Z., Bartlett, S. J., Brundage, M., Bryant-Lukosius, D., Krzyzanowska, M., Moody, L., Snyder, C., & Barbera, L. (2020). Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: The cancer care ontario approach. Journal of Patient-Reported Outcomes, 4(1), 101. https://doi.org/10.1186/s41687-020-00270-1CrossRefPubMedPubMedCentral

16.

NEJM Catalyst. (2019). Patient engagement buzz survey: PROMs use is growing but implementation takes effort. NEJM Catalyst, 5(5), 1–6. https://doi.org/10.1056/CAT.19.0704CrossRef

17.

Mou, D., Horn, D. M., Heng, M., Castillo-Angeles, M., Ladin, K., Frendl, D., Kaur, M., del Carmen, M., Sequist, T. D., & Sisodia, R. C. (2022). Primary care physician’s (PCP) perceived value of patient-reported outcomes (PROs) in clinical practice: A mixed methods study. BMJ Quality & Safety, 31(3), 221–229. https://doi.org/10.1136/bmjqs-2020-012206CrossRef

18.

Wu, A. W., White, S. M., Blackford, A. L., Wolff, A. C., Carducci, M. A., Herman, J. M., & Snyder, C. F. (2016). Improving an electronic system for measuring PROs in routine oncology practice. Journal of Cancer Survivorship : Research and Practice, 10(3), 573–582. https://doi.org/10.1007/s11764-015-0503-6CrossRefPubMed

19.

Basch, E., Deal, A. M., Kris, M. G., Scher, H. I., Hudis, C. A., Sabbatini, P., Rogak, L., Bennett, A. V., Dueck, A. C., Atkinson, T. M., Chou, J. F., Dulko, D., Sit, L., Barz, A., Novotny, P., Fruscione, M., Sloan, J. A., & Schrag, D. (2016). Symptom monitoring with patient-reported outcomes during routine cancer treatment: A randomized controlled trial. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 34(6), 557–565. https://doi.org/10.1200/JCO.2015.63.0830CrossRefPubMed

20.

Braeken, A. P. B. M., Kempen, G. I. J. M., Eekers, D. B. P., Houben, R. M. A., van Gils, F. C. J. M., Ambergen, T., & Lechner, L. (2013). Psychosocial screening effects on health-related outcomes in patients receiving radiotherapy. A cluster randomised controlled trial. Psycho-Oncology, 22(12), 2736–2746. https://doi.org/10.1002/pon.3340CrossRefPubMed

21.

Lizzio, V. A., Gulledge, C. M., Meta, F., Franovic, S., & Makhni, E. C. (2019). Using a web-based data collection platform to implement an effective electronic patient-reported outcome registry. Arthroscopy Techniques, 8(6), e535–e539. https://doi.org/10.1016/j.eats.2019.01.012CrossRefPubMedPubMedCentral

22.

van Egdom, L. S. E., Oemrawsingh, A., Verweij, L. M., Lingsma, H. F., Koppert, L. B., Verhoef, C., Klazinga, N. S., & Hazelzet, J. A. (2019). Implementing patient-reported outcome measures in clinical breast cancer care: A systematic review. Value in Health : The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 22(10), 1197–1226. https://doi.org/10.1016/j.jval.2019.04.1927CrossRefPubMed

23.

Sokas, C., Hu, F., Edelen, M., Sisodia, R., Pusic, A., & Cooper, Z. (2021). A review of PROM implementation in surgical practice. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000005029CrossRefPubMed

24.

Gelkopf, M., Mazor, Y., & Roe, D. (2021). A systematic review of patient-reported outcome measurement (PROM) and provider assessment in mental health: Goals, implementation, setting, measurement characteristics and barriers. International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care, 34(1), ii13–ii27. https://doi.org/10.1093/intqhc/mzz133CrossRefPubMed

25.

Singhal, S., Dickerson, J., Glover, M. J., Roy, M., Chiu, M., Ellis-Caleo, T., Hui, G., Tamayo, C., Loecher, N., Wong, H.-N., Heathcote, L. C., & Schapira, L. (2022). Patient-reported outcome measurement implementation in cancer survivors: A systematic review. Journal of Cancer Survivorship: Research and Practice. https://doi.org/10.1007/s11764-022-01216-wCrossRefPubMed

26.

Hyland, C. J., Guo, R., Dhawan, R., Kaur, M. N., Bain, P. A., Edelen, M. O., & Pusic, A. L. (2022). Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States. Journal of Patient-Reported Outcomes, 6(1), 20. https://doi.org/10.1186/s41687-022-00428-zCrossRefPubMedPubMedCentral

27.

Stover, A. M., Haverman, L., van Oers, H. A., Greenhalgh, J., & Potter, C. M. (2021). Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 30(11), 3015–3033. https://doi.org/10.1007/s11136-020-02564-9CrossRefPubMed

28.

Steinbeck, V., Ernst, S. C., & Pross, C. (2021). Patient-Reported Outcome Measures - an International Comparison. Technical University Berlin, Department of Healthcare Management. https://doi.org/10.11586/2021048

29.

Foster, A., Croot, L., Brazier, J., Harris, J., & O’Cathain, A. (2018). The facilitators and barriers to implementing patient reported outcome measures in organisations delivering health related services: A systematic review of reviews. Journal of Patient-Reported Outcomes, 2, 46. https://doi.org/10.1186/s41687-018-0072-3CrossRefPubMedPubMedCentral

30.

Mou, D., Mjaset, C., Sokas, C. M., Virji, A., Bokhour, B., Heng, M., Sisodia, R. C., Pusic, A. L., & Rosenthal, M. B. (2022). Impetus of US hospital leaders to invest in patient-reported outcome measures (PROMs): A qualitative study. British Medical Journal Open, 12(7), 061761. https://doi.org/10.1136/bmjopen-2022-061761CrossRef

31.

Brooks, J., McCluskey, S., Turley, E., & King, N. (2015). The utility of template analysis in qualitative psychology research. Qualitative Research in Psychology, 12(2), 202–222. https://doi.org/10.1080/14780887.2014.955224CrossRefPubMed

32.

Varpio, L., Ajjawi, R., Monrouxe, L. V., O’Brien, B. C., & Rees, C. E. (2017). Shedding the cobra effect: Problematising thematic emergence, triangulation, saturation and member checking. Medical Education, 51(1), 40–50. https://doi.org/10.1111/medu.13124CrossRefPubMed

33.

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science : IS, 4, 50. https://doi.org/10.1186/1748-5908-4-50CrossRefPubMedPubMedCentral

34.

O’Brien, B. C., Harris, I. B., Beckman, T. J., Reed, D. A., & Cook, D. A. (2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine : Journal of the Association of American Medical Colleges, 89(9), 1245–1251. https://doi.org/10.1097/ACM.0000000000000388CrossRefPubMed

35.

Antunes, B., Harding, R., & Higginson, I. J. (2014). Implementing patient-reported outcome measures in palliative care clinical practice: A systematic review of facilitators and barriers. Palliative Medicine, 28(2), 158–175. https://doi.org/10.1177/0269216313491619CrossRefPubMed

36.

Howell, D., Molloy, S., Wilkinson, K., Green, E., Orchard, K., Wang, K., & Liberty, J. (2015). Patient-reported outcomes in routine cancer clinical practice: A scoping review of use, impact on health outcomes, and implementation factors. Annals of Oncology : Official Journal of the European Society for Medical Oncology, 26(9), 1846–1858. https://doi.org/10.1093/annonc/mdv181CrossRefPubMed

37.

Franklin, P., Chenok, K., Lavalee, D., Love, R., Paxton, L., Segal, C., & Holve, E. (2017). Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system. EGEMS (Washington, DC), 5(1), 17. https://doi.org/10.5334/egems.227CrossRefPubMed

38.

van Muilekom, M. M., Teela, L., van Oers, H. A., van Goudoever, J. B., Grootenhuis, M. A., & Haverman, L. (2022). Patients’ and parents’ perspective on the implementation of patient reported outcome measures in pediatric clinical practice using the KLIK PROM portal. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 31(1), 241–254. https://doi.org/10.1007/s11136-021-02950-xCrossRefPubMed

39.

Nelson, J. A., Chu, J. J., Dabic, S., Kenworthy, E. O., Shamsunder, M. G., McCarthy, C. M., Mehrara, B. J., & Pusic, A. L. (2022). Moving towards patient-reported outcomes in routine clinical practice: Implementation lessons from the BREAST-Q. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. https://doi.org/10.1007/s11136-022-03213-zCrossRefPubMed

40.

Nordhausen, T., Lampe, K., Vordermark, D., Holzner, B., Al-Ali, H.-K., Meyer, G., & Schmidt, H. (2022). An implementation study of electronic assessment of patient-reported outcomes in inpatient radiation oncology. Journal of Patient-Reported Outcomes, 6(1), 77. https://doi.org/10.1186/s41687-022-00478-3CrossRefPubMedPubMedCentral

41.

Austin, E., LeRouge, C., Hartzler, A. L., Segal, C., & Lavallee, D. C. (2020). Capturing the patient voice: Implementing patient-reported outcomes across the health system. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 29(2), 347–355. https://doi.org/10.1007/s11136-019-02320-8CrossRefPubMed

42.

Santana, M. J., Haverman, L., Absolom, K., Takeuchi, E., Feeny, D., Grootenhuis, M., & Velikova, G. (2015). Training clinicians in how to use patient-reported outcome measures in routine clinical practice. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 24(7), 1707–1718. https://doi.org/10.1007/s11136-014-0903-5CrossRefPubMed

43.

Snyder, C., Crossnohere, N., King, M., Reeve, B. B., Bottomley, A., Calvert, M., Thorner, E., Wu, A. W., & Brundage, M. (2022). The PROTEUS-trials consortium: Optimizing the use of patient-reported outcomes in clinical trials. Clinical Trials, 19(3), 277–284. https://doi.org/10.1177/17407745221077691CrossRefPubMed

44.

Snyder, C., Gilbert, A., Moher, D., Kyte, D., Daniels, E., King, M., Calvert, M., Chen, R. C., & Brundage, M. (2021). Recommendations for including or reviewing patient reported outcome endpoints in grant applications. BMJ. https://doi.org/10.1136/bmj.n1367CrossRefPubMed

45.

Taliercio, V. L., Snyder, A. M., Biggs, A. M., Kean, J., Hess, R., Duffin, K. C., Cizik, A. M., & Secrest, A. M. (2022). Clinicians’ perspectives on the integration of electronic patient-reported outcomes into dermatology clinics: A qualitative study. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 31(6), 1719–1725. https://doi.org/10.1007/s11136-021-03030-wCrossRefPubMed

46.

Gensheimer, S. G., Wu, A. W., & Snyder, C. F. (2018). Oh, the places we’ll go: Patient-reported outcomes and electronic health records. Patient, 11(6), 591–598. https://doi.org/10.1007/s40271-018-0321-9CrossRefPubMed

47.

Forrest, C. B., McTigue, K. M., Hernandez, A. F., Cohen, L. W., Cruz, H., Haynes, K., Kaushal, R., Kho, A. N., Marsolo, K. A., Nair, V. P., Platt, R., Puro, J. E., Rothman, R. L., Shenkman, E. A., Waitman, L. R., Williams, N. A., & Carton, T. W. (2021). PCORnet® 2020: Current state, accomplishments, and future directions. Journal of Clinical Epidemiology, 129, 60–67. https://doi.org/10.1016/j.jclinepi.2020.09.036CrossRefPubMed

Titel: How to make PROMs work: qualitative insights from leaders at United States hospitals with successful PROMs programs
Publicatiedatum: 16-03-2023
Gepubliceerd in: Quality of Life Research / Uitgave 8/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-023-03388-z

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