State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable use

BMC Palliative Care

Research

Hannah Seipp¹  Jörg Haasenritter¹  Katrin Kuss¹  Stefan Bösner¹  Dania Schütze²  Jennifer Engler²  Dorothée Becker³  Michaela Hach³ 

[1]Department of General Practice and Family Medicine, Philipps-University of Marburg, Karl-Von-Frisch-Straße 4, 35032, Marburg, Germany

[2]Institute of General Practice, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

[3]Professional Association of Specialized, Palliative Homecare in Hesse, Weihergasse 15, 65203, Wiesbaden, Germany

关键词: Palliative care;    Home care services;    Quality of health care;    Patient reported outcome measures;    Routinely collected health data;    Implementation science;    Qualitative research;    Surveys and questionnaires;   

DOI  :  10.1186/s12904-022-01109-w

 received in 2022-08-17, accepted in 2022-11-18,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundSuch patient-reported outcome measures (PROMs) and patient-centered outcome measures as the Integrated Palliative Care Outcome Scale (IPOS), Phase of Illness, and IPOS Views on Care (IPOS VoC), facilitate patient-centered care and help improve quality. To ensure sustainability, implementation and usage should be adapted according to setting. When settings involve several distinct teams that differ in terms of views and working practices, it is more difficult to integrate outcome measures into daily care. The ELSAH study aimed to learn how health professionals working in specialized outpatient palliative care (SOPC) viewed the use of these outcome measures in daily care, and what they express is needed for successful sustainable, state-wide application.MethodsWe used a parallel mixed-methods design involving three focus groups (n = 14) and an online-survey based on normalization process theory (n = 76). Most participants were nurses and physicians from 19 SOPC-teams in Hesse, Germany. We used a triangulation protocol including convergence coding matrices to triangulate findings.ResultsThe majority of health professionals were able to integrate the outcome measures into their working lives and said that it had become a normal part of their day-to-day work. To ensure their sustainable integration into daily care, the motivation and concerns of health professionals should be taken into consideration. Health professionals must clearly recognize how the measures help improve daily care and quality evaluation.ConclusionsTo implement the outcome measures in a number of teams, it will be necessary to take individual team characteristics into account, because they influence motivation and concerncs. Further, it will be necessary to offer opportunities for them to engage in peer support and share information with other teams. The sustainable use of outcome measures in SOPC will require continuous support within each team as well as across teams. When several distinct teams are working in the same setting, a cross-team coordination unit can help to coordinate their work efficiently.Trial registrationGerman Clinical Trials Register DRKS-ID: DRKS00012421; www.germanctr.de/DRKS00012421

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 3