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在临床护理中实施患者报告结局测量的促进因素和障碍:学术中心的初步经验。

Facilitators and barriers for implementing patient-reported outcome measures in clinical care: An academic center's initial experience.

机构信息

Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.

Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.

出版信息

Health Policy. 2021 Sep;125(9):1247-1255. doi: 10.1016/j.healthpol.2021.07.001. Epub 2021 Jul 8.

Abstract

Objectives The aim of this study was to explore the perspectives of healthcare providers and researchers in a large academic hospital on facilitators and barriers for implementing patient-reported outcome measures (PROMs) in clinical care. Methods A customized web-based questionnaire was developed and disseminated to healthcare providers and researchers across multiple medical departments involved in a value-based health care initiative in the hospital. Questionnaire statements were rated using a 5-point Likert scale ranging from "strongly agree" to "strongly disagree". In addition, 8 open-ended questions were included allowing respondents to mention additional facilitators and barriers for implementing PROMs. Descriptive statistics were used to summarize the results. Results In total, 61 participants from both surgical and non-surgical departments completed the survey. Most respondents (51%) were medical specialists and the median employment duration was 14 years. Frequently reported facilitators were the presence of a PROM coordinator in the (outpatient) clinic (85%), the integration of PROMs in the electronic health record (81%), and the intrinsic motivation of members involved in the implementation (N=9 open responses). Commonly reported barriers were language barriers (76%), IT issues (N=17 open responses), and time constraints (N=14 open responses). Conclusions For the successful implementation of PROMs in clinical practice, it is imperative that healthcare organizations consider supporting motivated healthcare professionals, involving PROMs coordinators, and investing in an adequate IT infrastructure, and removal of language barriers.

摘要

目的 本研究旨在探讨大型学术医院的医疗保健提供者和研究人员对在临床护理中实施患者报告结局测量(PROMs)的促进因素和障碍的看法。

方法 开发了一个定制的基于网络的问卷,并分发给参与医院基于价值的医疗保健计划的多个医疗部门的医疗保健提供者和研究人员。问卷陈述采用 5 点李克特量表进行评分,范围从“非常同意”到“非常不同意”。此外,还包括 8 个开放式问题,允许受访者提及实施 PROMs 的其他促进因素和障碍。使用描述性统计来总结结果。

结果 共有来自外科和非外科部门的 61 名参与者完成了调查。大多数受访者(51%)是医学专家,平均工作年限为 14 年。经常被报道的促进因素是门诊(85%)诊所中存在 PROM 协调员、PROM 整合到电子健康记录中(81%)以及参与实施的成员的内在动机(9 个开放响应)。常见的障碍是语言障碍(76%)、IT 问题(17 个开放响应)和时间限制(14 个开放响应)。

结论 为了在临床实践中成功实施 PROMs,医疗保健组织必须考虑支持有动力的医疗保健专业人员、纳入 PROM 协调员、投资于足够的 IT 基础设施以及消除语言障碍。

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