Routine Collection of Patient-Reported Outcomes in Thoracic Surgery: A Quality Improvement Study
| Autor: | Tracey J. Guthrie, Melanie P. Subramanian, Bryan F. Meyers, Christian Oncken, Angela D. Keith, Mary Anne Lenk, Benjamin D. Kozower, Alexander Patterson, Brendan T. Heiden, Varun Puri, Deirdre J. Epstein, Ruben G. Nava |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Patient-Reported Outcomes Measurement Information System Quality management business.industry Psychological intervention MEDLINE Reproducibility of Results Thoracic Surgery medicine.disease Quality Improvement Cardiothoracic surgery Surveys and Questionnaires medicine Humans Surgery Patient-reported outcome Computerized adaptive testing Medical emergency Patient Reported Outcome Measures Cardiology and Cardiovascular Medicine business PDCA |
| Zdroj: | The Annals of thoracic surgery. 113(6) |
| ISSN: | 1552-6259 |
| Popis: | Background Patient reported outcomes (PROs) are critical for delivering high quality surgical care yet they are seldom collected in routine clinical practice. The objective of this quality improvement study was to improve routine PROs collection in a thoracic surgery clinic. Methods Thoracic surgery patients at a single academic institution were prospectively followed from April 2019 to March 2020. The National Institutes of Health (NIH)-validated Patient-Reported Outcomes Measurement Information System (PROMIS) was employed. Using a Model for Improvement design and through multidisciplinary participant observation, multiple plan-do-study-act (PDSA) cycles (an iterative, four-stage model for rapidly testing interventions) were performed to improve routine collection reliability. Results Over the study period, a total of 2,315 patient visits occurred. The baseline PROMIS assessment collection rate was 53%. After convening a multidisciplinary stakeholder team, the key drivers for PROMIS collection were having engaged staff, engaged patients, adequate technological capacity, and adequate time for survey completion (including when to complete the survey during the patient visits). Regular meetings between stakeholders were initiated to promote these key drivers. Several PDSA cycles were then employed to test different interventions, resulting in several positive system shifts as demonstrated on statistical process control (SPC) chart. Adherence to survey collection reached 91% of office visits by approximately 7 months, a 72% relative improvement, which was sustained. Conclusions Routine collection of PROs, such as PROMIS, are critical for improving thoracic surgical care. Our study shows that reliably collecting these data is possible in a clinical setting with minimal additional hospital resources. |
| Databáze: | OpenAIRE |
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