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

Hyland, Colby J.; Mou, Danny; Virji, Azan Z.; Sokas, Claire; Bokhour, Barbara G.; Pusic, Andrea L.; Mjåset, Christer

doi:10.1007/s11136-023-03388-z

Cited by 8 publications

(4 citation statements)

References 49 publications

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“…One of the suggestions in this survey was dedicating a nurse navigator or care coordinator for the implementation and follow-up of (e)PROMs. Employing a nurse navigator for (e)PROM follow-up seems a good idea and has been suggested in other studies as well [ 31 , 35 , 40 ]. Continuous support from a nurse navigator could provide patients with better continuity of care, especially as radiotherapy plays only a small part in the care of palliative patients.…”

Section: Discussionmentioning

confidence: 99%

“…As (e)PROMs can provide crucial information about patient experiences during cancer trajectories, their use in clinical practice is becoming increasingly advocated [ 10 ]. However, their implementation and adoption in routine clinical practice has shown to be challenging [ 31 ]. Additionally, the evidence for the impact of (e)PROMs on routine clinical practices, such as prompting appropriate referrals, is reported to be weak or ambiguous.…”

Section: Introductionmentioning

confidence: 99%

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The use of electronic Patient Reported Outcomes in follow-up after palliative radiotherapy: A survey study in Belgium

Oldenburger,

Isebaert,

Coolbrandt

et al. 2023

PEC Innovation

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of electronic Patient Reported Outcomes in follow-up after palliative radiotherapy: A survey study in Belgium

Oldenburger,

Isebaert,

Coolbrandt

et al. 2023

PEC Innovation

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“…Within surgical quality, current measures emphasize processes, adverse events (eg, complications), and resource use, which are necessary to track but do not provide a complete picture of the recovery, symptoms, and outcomes that patients experience . However, the implementation of PROMs for surgical quality improvement remains restricted to single centers and has not been ingrained into quality improvement thinking …”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Outcome Measures Within a National Multispecialty Surgical Quality Improvement Program

Temple,

Pusic,

Liu

et al. 2024

JAMA Surg

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ImportancePatient-reported outcome measures (PROMs) are increasingly recognized for their ability to promote patient-centered care, but concerted health information technology (HIT)–enabled PROM implementations have yet to be achieved for national surgical quality improvement.ObjectiveTo evaluate the feasibility of collecting PROMs within a national surgical quality improvement program.Design, Setting, and ParticipantsThis was a pragmatic implementation cohort study conducted from February 2020 to March 2023. Hospitals in the US participating in the American College of Surgeons National Surgical Quality Improvement Program and their patients were included in this analysis.ExposuresStrategies to increase PROM collection rates were identified using the Institute for Healthcare Improvement (IHI) Framework for Spread and the Consolidated Framework for Implementation Research and operationalized with the IHI Model for Improvement’s Plan-Do-Study-Act (PDSA) cycles.Main Outcomes and MeasuresThe primary goal was to accrue more than 30 hospitals and achieve collection rates of 30% or greater in the first 3 years. Logistic regression was used to identify hospital-level factors associated with achieving collection rates of 30% or greater and to identify patient-level factors associated with response to PROMs.ResultsAt project close, 65 hospitals administered PROMs to 130 365 patients (median [IQR] age, 60.1 [46.2-70.0] years; 77 369 female [59.4%]). Fifteen PDSA cycles were conducted to facilitate implementation, primarily targeting the Consolidated Framework for Implementation Research domains of Inner Setting (ie, HIT platform) and Individuals (ie, patients). The target collection rate was exceeded in quarter 3 (2022). Fifty-eight hospitals (89.2%) achieved collection rates of 30% or greater, and 9 (13.8%) achieved collection rates of 50% or greater. The median (IQR) maximum hospital-level collection rate was 40.7% (34.6%-46.7%). The greatest increases in collection rates occurred when both email and short-message service text messaging were used, communications to patients were personalized with their surgeon’s and hospital’s information, and the number of reminders increased from 2 to 5. No identifiable hospital characteristic was associated with achieving the target collection rate. Patient age and insurance status contributed to nonresponse.Conclusions and RelevanceResults of this cohort study suggest that the large-scale electronic collection of PROMs into a national multispecialty surgical registry was feasible. Findings suggest that HIT platform functionality and earning patient trust were the keys to success; although, iterative opportunities to increase collection rates and address nonresponse remain. Future work to drive continuous surgical quality improvement with PROMs are ongoing.

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“…While electronic administration of PROMs that is automatically integrated with the EHR may ease patient and staff burdens associated with MBC, this system of screening may not be accessible in all health care settings. This type of system requires an information technology team that can help build and maintain the electronic PRO system, which can take a significant amount of time and expense and can also lead to recurring technological challenges once implemented [ 2 , 12 , 13 ]. In health safety net hospitals or federally qualified health centers, there may be fewer resources to incorporate the necessary information technology changes needed to systematically screen patients using electronic devices integrated with the EHR [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a 2-Part Substance Use Screener Self-Administered by Patients on Paper: Observational Study

Kramer,

Wilens,

Rao

et al. 2024

JMIR Form Res

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Background: Measurement based care (MBC) utilizes patient reported outcome measures (PROMs) to screen for mental health symptoms and assess symptom change over time. While PROMs are increasingly being integrated into electronic health record systems, paper-based PROMs continue to be utilized, and it is unclear if electronic and paper administration are equivalent when a PROM was initially developed for electronic administration.Objective: This study aimed to examine the feasibility of a patient-administered two-part substance use screener, the Tobacco, Alcohol, Prescription medication, and other substances (TAPS) screener, originally created for electronic administration, on paper in an urgent care behavioral health clinic within an urban, public safety net hospital. Methods:Research staff examined screener response patterns.Results: Out of the 507 new patients, 313 completed the TAPS (61.7%). Among those who completed the TAPS, 237 (75.7%) did not follow the instructions correctly, and most answered more questions than needed.Conclusions: When selecting PROMs for MBC it is important to consider necessary adaptations based on how the PROM will be administered.

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

Cited by 8 publications

References 49 publications

The use of electronic Patient Reported Outcomes in follow-up after palliative radiotherapy: A survey study in Belgium

The use of electronic Patient Reported Outcomes in follow-up after palliative radiotherapy: A survey study in Belgium

Patient-Reported Outcome Measures Within a National Multispecialty Surgical Quality Improvement Program

Feasibility of a 2-Part Substance Use Screener Self-Administered by Patients on Paper: Observational Study

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