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Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q
PURPOSE: Longitudinal, routine utilization of patient-reported outcome measures (PROMs) in clinical care has been challenging. The purpose of this study is to describe a quality improvement initiative to improve patient engagement with the BREAST-Q, a gold-standard PROM for breast reconstruction. ME...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380681/ https://www.ncbi.nlm.nih.gov/pubmed/35972615 http://dx.doi.org/10.1007/s11136-022-03213-z |
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author | Nelson, Jonas A. Chu, Jacqueline J. Dabic, Stefan Kenworthy, Elizabeth O. Shamsunder, Meghana G. McCarthy, Colleen M. Mehrara, Babak J. Pusic, Andrea L. |
author_facet | Nelson, Jonas A. Chu, Jacqueline J. Dabic, Stefan Kenworthy, Elizabeth O. Shamsunder, Meghana G. McCarthy, Colleen M. Mehrara, Babak J. Pusic, Andrea L. |
author_sort | Nelson, Jonas A. |
collection | PubMed |
description | PURPOSE: Longitudinal, routine utilization of patient-reported outcome measures (PROMs) in clinical care has been challenging. The purpose of this study is to describe a quality improvement initiative to improve patient engagement with the BREAST-Q, a gold-standard PROM for breast reconstruction. METHODS: In 2011, we implemented the BREAST-Q as part of routine care. In 2018, we began a quality improvement initiative to increase BREAST-Q patient participation. The BREAST-Q was administered at every clinic visit via an institutional patient portal or an in-clinic tablet; digital dashboard technologies were used to improve workflow integration, real-time accountability, and immediate data availability at clinic visits. High clinical staff engagement was encouraged by assigning “BREAST-Q Champions.” BREAST-Q completion data and patient characteristics were examined to understand non-response to the assessment. RESULTS: Following quality improvement, the average annual BREAST-Q completion rate increased from 42.8% in 2011–2017 to 87.6% in 2019, the last full year of our study period. High completion rates were maintained January–July 2020; however, a significantly larger proportion of BREAST-Qs were completed at home in 2020 versus the same period in 2019 (49.7 vs. 38.8%, p < 0.001), potentially due to the COVID-19 pandemic. Compared with non-responders, responders were younger (49.7 vs. 52.2 years, p < 0.001), more likely to be white (76.9 vs. 73.6%, p < 0.001), and had private insurance (79.4 vs. 69.8%, p < 0.001). CONCLUSION: Our quality improvement initiative successfully increased routine completion of the BREAST-Q. Similar implementation techniques may prove beneficial at other institutions interested in incorporating PROMs into routine care. |
format | Online Article Text |
id | pubmed-9380681 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-93806812022-08-17 Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q Nelson, Jonas A. Chu, Jacqueline J. Dabic, Stefan Kenworthy, Elizabeth O. Shamsunder, Meghana G. McCarthy, Colleen M. Mehrara, Babak J. Pusic, Andrea L. Qual Life Res Article PURPOSE: Longitudinal, routine utilization of patient-reported outcome measures (PROMs) in clinical care has been challenging. The purpose of this study is to describe a quality improvement initiative to improve patient engagement with the BREAST-Q, a gold-standard PROM for breast reconstruction. METHODS: In 2011, we implemented the BREAST-Q as part of routine care. In 2018, we began a quality improvement initiative to increase BREAST-Q patient participation. The BREAST-Q was administered at every clinic visit via an institutional patient portal or an in-clinic tablet; digital dashboard technologies were used to improve workflow integration, real-time accountability, and immediate data availability at clinic visits. High clinical staff engagement was encouraged by assigning “BREAST-Q Champions.” BREAST-Q completion data and patient characteristics were examined to understand non-response to the assessment. RESULTS: Following quality improvement, the average annual BREAST-Q completion rate increased from 42.8% in 2011–2017 to 87.6% in 2019, the last full year of our study period. High completion rates were maintained January–July 2020; however, a significantly larger proportion of BREAST-Qs were completed at home in 2020 versus the same period in 2019 (49.7 vs. 38.8%, p < 0.001), potentially due to the COVID-19 pandemic. Compared with non-responders, responders were younger (49.7 vs. 52.2 years, p < 0.001), more likely to be white (76.9 vs. 73.6%, p < 0.001), and had private insurance (79.4 vs. 69.8%, p < 0.001). CONCLUSION: Our quality improvement initiative successfully increased routine completion of the BREAST-Q. Similar implementation techniques may prove beneficial at other institutions interested in incorporating PROMs into routine care. Springer International Publishing 2022-08-16 2023 /pmc/articles/PMC9380681/ /pubmed/35972615 http://dx.doi.org/10.1007/s11136-022-03213-z Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Article Nelson, Jonas A. Chu, Jacqueline J. Dabic, Stefan Kenworthy, Elizabeth O. Shamsunder, Meghana G. McCarthy, Colleen M. Mehrara, Babak J. Pusic, Andrea L. Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title | Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title_full | Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title_fullStr | Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title_full_unstemmed | Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title_short | Moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the BREAST-Q |
title_sort | moving towards patient-reported outcomes in routine clinical practice: implementation lessons from the breast-q |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380681/ https://www.ncbi.nlm.nih.gov/pubmed/35972615 http://dx.doi.org/10.1007/s11136-022-03213-z |
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