Psychosocial Department, G8-136, Emma Children's Hospital/Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Postbox 2266, 1100 DD, Amsterdam, The Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Qual Life Res. 2021 Nov;30(11):3049-3061. doi: 10.1007/s11136-020-02586-3. Epub 2020 Aug 15.
The KLIK Patient-Reported Outcome Measure (PROM) portal is an evidence-based intervention implemented in clinical practice in > 25 Dutch hospitals for patients (children and adults) who regularly visit the outpatient clinic. Implementation science frameworks can be used to understand why implementation succeeded or failed, to structure barriers and enablers, and to develop implementation strategies to overcome barriers. This paper aimed to (A) retrospectively describe determinants of successful KLIK PROM implementation using the Consolidated Framework for Implementation Research (CFIR), and (B) identify current barriers and match implementation strategies.
(A) The KLIK implementation process was described retrospectively based on literature and experience, using the 39 CFIR constructs organized in five general domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and implementation process. (B) The CFIR-Expert Recommendations for Implementing Change (ERIC) Implementation Strategy Matching tool identified current barriers in the KLIK implementation and matched implementation strategies that addressed the identified barriers.
(A) The most prominent determinants of successful KLIK PROM implementation lie in the following CFIR domains: intervention characteristics (e.g., easy to use), characteristics of individuals (e.g., motivation), and process of implementation (e.g., support). (B) 13 CFIR constructs were identified as current barriers for implementing the KLIK PROM portal. The highest overall advised ERIC strategy for the specific KLIK barriers was to identify and prepare champions.
Using an implementation science framework, e.g., CFIR, is recommended for groups starting to use PROMs in clinical care as it offers a structured approach and provides insight into possible enablers and barriers.
KLIK 患者报告结局测量（PROM）门户是在临床实践中为定期就诊于门诊的患者（儿童和成人）实施的一项循证干预措施，已在超过 25 家荷兰医院实施。实施科学框架可用于了解实施成功或失败的原因，构建障碍和促进因素，并制定克服障碍的实施策略。本文旨在（A）使用实施研究综合框架（CFIR）回顾性描述 KLIK PROM 实施的成功决定因素，以及（B）确定当前的障碍并匹配实施策略。
（A）根据文献和经验，使用 CFIR 的 39 个构建体组织的五个一般领域（干预特征、外部环境、内部环境、个体特征和实施过程），回顾性描述 KLIK 实施过程。（B）CFIR-实施变革专家建议（ERIC）实施策略匹配工具确定了 KLIK 实施中的当前障碍，并匹配了针对已确定障碍的实施策略。
（A）KLIK PROM 成功实施的最突出决定因素在于以下 CFIR 领域：干预特征（例如，易于使用）、个体特征（例如，动机）和实施过程（例如，支持）。（B）确定了 13 个 CFIR 结构作为实施 KLIK PROM 门户的当前障碍。针对特定 KLIK 障碍，总体建议的最高 ERIC 策略是确定和培养拥护者。
建议使用实施科学框架（例如，CFIR），为开始将 PROM 用于临床护理的团体提供一种结构化的方法，并深入了解可能的促进因素和障碍。
