A research study to identify facilitators and barriers to outcome measure implementation

Abstract

Aim To identify facilitators and barriers to implementing outcome measures. Methods An action-research approach within a hospice and nursing home was used. Staff took part in semistructured interviews pre- and post-implementation of the Palliative Care Outcome Scale (POS), completed diaries and participated in monthly meetings. Findings Qualitative content analysis identified barriers to implementation including: a top-down decision-making approach; outcome measures perceived as time-consuming to use; limited resources for data analysis; and a lack of knowledge of the importance of outcome measures. Facilitators to successful implementation include: involving all staff in decisions about implementation; and using a measure that can be adapted to organization needs and clinical practice. The benefits of using the measure are rapidly noticeable. Conclusions Given the need to evaluate services and the role outcome measures can have within clinical governance, this article indicates methods by which measures may be more successfully implemented.

Enhancing patient-reported outcome measurement in research and practice of palliative and end-of-life care

“…Although the workshop was facilitated by the European coordination project PRISMA, we invited participants from Eastern Europe, Canada, and Africa to strengthen international links. This placed the discussions in a collaborative and international framework that allowed formulating an action plan on further development and support of PROMs in palliative and EOL care across Europe [3]. The findings and conclusions of the workshop could have been strengthened by a formal consensus process (e.g., Delphi) based upon the qualitative results of findings and discussions.…”

“…Patient-reported outcome measurement (PROMs) play an increasing role in palliative and end-of-life (EOL) care but their use in EOL care and research remains varied and inconsistent, with often diverse measures being used once or twice only [1][2][3]. EOL care faces various complexities influencing the measurement of outcomes: (i) patients may report multiple symptoms rather than one problem, (ii) problems and symptoms are often complex (e.g., fatigue and spiritual problems), and (iii) patients go through different stages in their disease trajectory including the experience of deterioration at the end of life, with changing priorities and reduced physical and cognitive function [4].…”

First assessments by specialist cancer nurses in the community: An ethnography

“…Sexual, financial, and spiritual matters are recognised as difficult for health care practitioners to enquire about (Crooks et al, 2004) because it can feel an unacceptable intrusion (Dunckley et al, 2005). The SCC makes provision for a patient to self-score their concerns regarding sexual or spiritual issues but there is disquiet described in the literature and shared by the participants in this study about asking about these domains (Heaven and Maguire, 1998).…”

“…Little is known about professionals' views and experiences of using assessment tools and some negative views have been reported about their use (Hughes et al, 2003;Baba et al, 2007). Issues found to be important when implementing assessment tools were time constraints, staff workload, training and the potential burden on the patient (Hughes et al, 2003;Dunckley et al, 2005).…”

Becoming Competent in Palliative Care as Perceived by Nurses Attending a Master Programme. A Qualitative Study

“…Qualitative instruments as interviews, focus groups (FGs), and autobiographical writings could be useful to explore that aspect of nurses' expertise and to better evaluate the development of competence in PC during and after training experiences [33][34][35].…”