New study on advancing patient-reported outcome measures to increase patient-centered care
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(OAKBROOK TERRACE, Illinois, August 1, 2018) – Interest is growing in using patients’ own reports of their health–patient-reported outcomes, or PROs–to measure quality of life and use performance on these measures for payer incentives that reward higher quality care and better outcomes. PROs collect information directly from patients about their perceptions of their health, quality of life, mental well-being or health care experience.
Many organizations have struggled with how to implement and standardize PRO measure collection into routine practice. A new study in the August 2018 issue of The Joint Commission Journal on Quality and Patient Safety, “Systemwide Implementation of Patient-Reported Outcomes in Routine Clinical Care at a Children’s Hospital,” by Wendy E. Gerhardt, MSN, RN-BC, director, Quality Outcomes and Evidence, James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, and co-authors, details how a PRO implementation program at Cincinnati Children’s can serve as a model for using PROs in a clinical setting.
The program entailed a committed clinical leader and teams; selection of an instrument that addresses the identified outcomes of interest; specification of threshold scores that indicate when a patient is not improving as expected and intervention is needed; identification of clinical interventions to be triggered by threshold scores; provision of training for providers and staff involved in the PRO implementation process; and the measurement and monitoring of PRO use.
The completion goal for each instrument was 80 percent, defined as the number of PRO measures actually completed divided by the number that should have been completed. Findings showed the overall combined completion rate was 75 percent for 68 unique instruments used. Case studies of specific clinical team experiences demonstrate the value of using PROs and the implementation components, and how PROs are used to promote patient-centered care, according to the authors.
In an accompanying editorial, “How Can Health Systems Advance Patient-Reported Outcome Measurement,” Danielle C. Lavallee, PharmD, PhD, research associate professor, University of Washington, Seattle, and co-authors, explain that although guidelines and recommendations exist to help clinicians navigate the methodological and practical decisions to implement measurement of PROs in practice, little has been written to guide development of a standardized system.
“Achieving patient-centered care requires that health care systems address patients’ health-related quality of life and emotional well-being, as well as their physical health. Although clinical measures and metrics are well ingrained in health care delivery, the same is not true for systematic approaches to integrating the patient’s voice into care delivery and documentation,” note the authors.
Also featured in the August 2018 issue:
- “Improving Access to Care by Admission Process Redesign in a Veterans Affairs Skilled Nursing Facility” (U.S. Department of Veterans Affairs)
- “A Road Map for Advancing the Practice of Respect in Health Care: The Results of an Interdisciplinary Modified Delphi Consensus Study” (32 participants across the country)
- “Use of an Emergency Manual During Intraoperative Cardiac Arrest by an Interprofessional Team: A Positive-Exemplar Case Study of a New Patient Safety Tool” (Massachusetts General Hospital, Boston)
- “Workin’ on Our Night Moves”: How Residents Prepare for Shift Handoffs” (U.S. Department of Veterans Affairs)
- “Respiratory Rate: The Forgotten Vital Sign—Make It Count!” (Kritikus Foundation, Redding, California)
- “Choosing Wisely to Mobilize Patients in Reducing Falls and Injury” (Mount Sinai Hospital, New York City)
For more information, visit The Joint Commission Journal on Quality and Patient Safety website.
Note for editors
The article is “Systemwide Implementation of Patient-Reported Outcomes in Routine Clinical Care at a Children’s Hospital,” by Wendy E. Gerhardt, MSN, RN-BC; Constance A. Mara, PhD; Ian Kudel, PhD; Esi M. Morgan, MD, MSCE; Pamela J. Schoettker, MS; Jason Napora, BA; Maria T. Britto, MD, MPH; and Evaline A. Alessandrini, MD, MSCE. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 8 (August 2018), published by Elsevier.
The editorial is “How Can Health Systems Advance Patient-Reported Outcome Measurement,” by Danielle C. Lavallee, PharmD, PhD; Elizabeth Austin, MPH; and Patricia D. Franklin, MD, MBA, MPH. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 8 (August 2018), published by Elsevier.
The Joint Commission Journal on Quality and Patient Safety
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.
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