利益相关者对在卫生系统中实施和整合患者报告结果措施(PROMs)的观点——来自加拿大阿尔伯塔省的见解。

IF 2.9 Q2 HEALTH CARE SCIENCES & SERVICES
Fatima Al Sayah, Hilary Short, Arto Ohinmaa, Stafford Dean, Brenda Hubley, Markus Lahtinen, Jeffrey A Johnson
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引用次数: 0

摘要

背景:患者报告的结果测量(PROMs)是评估卫生保健干预结果的宝贵工具,在世界各地的卫生系统中越来越多地使用。虽然prom的采用在全球范围内增长,但它们在整个卫生系统中的使用存在差异。这个利益相关者参与和咨询活动旨在了解影响prom采用、实施和利用的因素,并确定在加拿大阿尔伯塔省的医疗保健系统中提高prom数据利用的策略。方法:采访了来自不同角色的关键利益相关者,包括PROMs项目、卫生系统改进、数据分析、临床实践、评估、卫生经济学和研究,他们来自不同的临床领域,包括癌症、初级保健、癫痫、康复、关节成形术、心血管手术和风湿病学。访谈被记录、转录并使用专题分析进行分析。使用实施研究统一框架(CFIR)和创新扩散框架(DOI)对结果进行综合。结果:共完成了25次访谈,时长在45到60分钟之间。影响阿尔伯塔省医疗保健系统采用、实施和利用PROMs的因素包括:(1)干预特征:对PROMs的共同理解、获取相关患者结果的挑战、PROMs的标准化和整合、数据收集的模式、使PROMs在患者-临床层面可操作以及解释PROMs数据;(2)内部环境:文化转向以患者为中心的护理,改变管理和临床医生的心态,组织承诺和支持,融入更广泛的测量框架,获取PROMs数据,复制和适应的潜力,以及激励和要求的重要性;(3)外部环境:资源限制,政策和系统挑战,注重基于价值的护理,负责任地使用prom数据;(4)个人特征:对prom的专业知识和理解,利益相关者的参与和教育;(5)过程:平衡自底向上和自顶向下的方法、工作流集成、患者参与以及持续评估和质量改进。结论:该研究强调了影响阿尔伯塔省采用prom的因素,包括对统一理解、工作流集成和电子数据使用的需求。关键策略包括促进以患者为中心的护理,确保组织支持,解决资源和政策问题,以及提供有针对性的教育。吸引早期采用者并提供激励可以改善PROMs的整合和患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stakeholders' perspectives on implementing and integrating patient-reported outcome measures (PROMs) in health systems - insights from Alberta, Canada.

Background: Patient-reported outcome measures (PROMs) are valuable tools for evaluating outcomes of healthcare interventions and have been increasingly used in health systems around the world. While PROMs adoption has grown globally, variations exist in their use across the health system. This stakeholder engagement and consultation activity aims to understand factors impacting PROMs adoption, implementation, and utilization, and identify strategies for enhancing utilization of PROMs data within the healthcare system in Alberta, Canada.

Methodology: Key stakeholders from various roles were interviewed, including PROMs programs, health system improvement, data analytics, clinical practice, evaluation, health economics, and research, from diverse clinical areas, including cancer, primary care, epilepsy, rehabilitation, arthroplasty, cardiovascular surgery, and rheumatology. Interviews were recorded, transcribed and analyzed using thematic analysis. Results were synthesized using the Consolidated Framework for Implementation Research (CFIR) and Diffusion of Innovation Framework (DOI).

Results: A total of 25 interviews, lasting between 45 and 60 minutes, were completed. Factors impacting the adoption, implementation and utilization of PROMs within the Alberta healthcare system included: (1) Intervention characteristics: shared understanding of PROMs, challenges in capturing relevant patient outcomes, standardization and integration of PROMs, modalities of data collection, making PROMs actionable at the patient-clinician level, and interpreting PROMs data; (2) Inner setting: Cultural shift towards patient-centered care, change management and clinician mindset, organizational commitment and support, integration into broader measurement frameworks, access to PROMs data, potential for replication and adaptation, and importance of incentives and requirements; (3) Outer setting: Resource constraints, policy and systemic challenges, focus on value-based care, and responsible use of PROMs data; (4) Characteristics of individuals: Expertise and understanding of PROMs, and stakeholder engagement and education; and (5) Process: Balancing bottom-up and top-down approaches, workflow integration, patient engagement, and continuous evaluation and quality improvement.

Conclusions: The study highlights factors influencing PROMs adoption in Alberta, including the need for a unified understanding, workflow integration, and electronic data use. Key strategies involve fostering patient-centered care, ensuring organizational support, addressing resource and policy issues, and providing targeted education. Engaging early adopters and offering incentives can improve PROMs integration and patient outcomes.

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来源期刊
Journal of Patient-Reported Outcomes
Journal of Patient-Reported Outcomes Health Professions-Health Information Management
CiteScore
3.80
自引率
7.40%
发文量
120
审稿时长
20 weeks
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