Identifying Barriers to Low Completion Rates of Symptoms Screening via Electronic Patient-Reported Outcome Measures (ePROMs) among Patients Receiving Radiation Therapy Treatments at Stronach Regional Cancer Centre (SRCC)

Abstract

Purpose/Aim

Symptom screening, branded as Your Symptoms Matter (YSM), via Patient-Reported Outcome Measures (PROMs) is a vital component of cancer care. It is well documented in the literature that when completion rates for PROMs are low, it can lead to incomplete patient-reported data limiting healthcare providers' understanding of patient symptom burden. This can ultimately hinder effective and timely symptom management, access to resources crucial to providing personalized care and have negative impacts on quality of life. As per OH-CCO recommendation, patients are encouraged to complete PROMs surveys via online or at touchscreen kiosks at the Cancer Centres. Current completion rates via electronic PROMs (ePROMs) remain low at our department. Majority of patients rely on physical paper form – which imposes problems including waste of resources that are already available, increased administrative workload for staff as they have to transcribe results manually, as well as accuracy of the data can be compromised during manual data entry. Improvement of YSM completion rates is a strategic goal for our Cancer Centre to ensure compliance of best practice in providing patient-centered care. This project will analyze our current YSM completion rate via ePROMs and explore the major barriers of using ePROMs by patients in our centre.

Methods/Process

To understand our current YSM completion rates via ePROMs, we will be extracting PROMs completion data from the electronic patient record (MosaiQ) and find out the proportion of patients completing YSM utilizing ePROMs. To better understand and identify the root causes of low YSM completion rates via ePROMS, a survey outlining the major barriers of using ePROMs by patients from the literature, will be performed by both staff and patients. We will then further analyze these causes utilizing different diagnostics tools including a Fishbone diagram, 5-Why's as well as a Pareto to identify, analyze, and address the root causes of problems by providing clear data and insights. A driver diagram will also be created based on these findings, where change ideas will be developed and implemented in the next phase of the project.

Results or Benefits/Challenges

YSM completion rate via ePROMs for the radiation therapy department during April to June of 2024 was low, particularly, completion of YSM using kiosks was below 20 during the analyzed period. An anonymous staff survey was conducted among forty-five radiation therapists, as well as four oncology nurses to identify the top three causes that staff consider as main causes for low utilization of touchscreen computer kiosks. A total of seventeen completed surveys were collected in the end.

Conclusions/Impact

The three root causes contributed to low completion rate of YSM via ePROMs in our department include: “No one had explored other potential locations for the touchscreen computer”, “Staff may not understand the benefits and how easy it is to complete symptoms screening using ePROMs to complete YSM”, as well as “There was no continuous monitoring of updating workflow to include ePROMs”. The next phase of the project will involve implementation of a number of plan-do-study-act (PDSA) cycles implementing the identified change ideas and, evaluate YSM completion rates via ePROMs with the improvement efforts.