Improving PROMs collection rate in an outpatient palliative care clinic
| Autor: | Jocelyn Siegel, Isaac S. Chua, Victoria Hayne, Nadine Jackson McCleary |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Cancer Research
Palliative care business.industry Paper version Dana-Farber Cancer Institute Common Terminology Criteria for Adverse Events medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Primary outcome Oncology 030220 oncology & carcinogenesis Medicine Medical emergency business PDCA |
| Zdroj: | Journal of Clinical Oncology. 36:105-105 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | 105 Background: From January 2018 to March 2018, Dana Farber Cancer Institute (DFCI) launched a pilot to collect Patient-Reported Outcomes of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) within the adult palliative care (APC) clinic using smart tablets. We had a limited response rate—only 20% of patients attempted to complete the questionnaire. After the pilot ended on March 2018, smart tablets were discontinued and were replaced with a paper version of PRO-CTCAE from April to June 2018. Our aim was to increase the patient attempt and collection rate of the paper PRO-CTCAE from 20% to 50%. Methods: Our primary outcome measure was the percentage of paper PRO-CTCAE attempted and collected. Eligible patients were established patients scheduled to see a provider in the APC clinic. We implemented several Plan-Do-Study-Act (PDSA) cycles including the implementation of the paper version of the questionnaire, training and educating front desk staff, and posting provider reminders in exam rooms. We used a statistical process control (SPC) chart to track percentage of attempted and collected questionnaires over time and to differentiate between special cause and common cause variation. Results: From April 2018 to June 2018, the PRO-CTCAE collection rate improved from 20% to 48%. Special cause variation was associated with implementation of the paper version of the PRO-CTCAE and increased front desk staff engagement. Increased provider satisfaction was also associated with the paper version of the PRO-CTCAE. Conclusions: Implementing a high-reliability process for collecting patient reported outcome measures in an outpatient palliative care clinic is complex and requires cohesive multi-disciplinary teamwork, a user-friendly patient-facing and provider-facing interface, and a streamlined workflow. The electronic version of PRO-CTCAE will resume in September 2018. We will implement lessons learned from the paper PRO-CTCAE implementation, including ongoing front desk staff engagement and an enhanced provider view in the electronic medical record. |
| Databáze: | OpenAIRE |
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