Development of the ‘AusPROM’ recommendations for elective surgery patients
Natasha K. Brusco A B C , Paul S. Myles
D , Victoria Atkinson A E , Jeffrey Woods A E , Anita Hodge A E , Cathy Jones A F , Damien Lloyd A E , Vincent Rovtar E , Amanda M. Clifford G , Tom Wood E and Meg E. Morris A H *
A Academic and Research Collaborative in Health (ARCH), La Trobe University, Bundoora, Vic., Australia.
B Alpha Crucis Group, Melbourne, Vic., Australia.
C Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Vic., Australia.
D Department of Anaesthesiology and Perioperative Medicine, Alfred Hospital and Monash University Central Clinical School, Melbourne, Vic., Australia.
E Healthscope Limited, Melbourne, Vic., Australia.
F Cathy Jones Consulting, Melbourne, Vic., Australia.
G School of Allied Health, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland.
H Victorian Rehabilitation Centre, Healthscope Limited, Glen Waverley, Melbourne, Vic., Australia.
Australian Health Review 46(5) 621-628 https://doi.org/10.1071/AH22074
Submitted: 24 March 2022 Accepted: 12 June 2022 Published: 22 July 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objective Implementing the routine collection of patient reported outcome measures (PROMs) is key to improving healthcare quality and patient satisfaction. The implementation process can be strengthened through staff and patient co-design. The aim of this project was to develop a set of Australian PROM implementation recommendations (‘AusPROM’) to guide rapid translation into practice.
Methods Staff working across 29 Australian private hospitals participated in the project. The hospitals provided elective surgery and spanned each state and territory of Australia. Staff engaged in a Delphi technique to develop the AusPROM, which involved three iterative focus groups. To ensure full disclosure, staff were also provided with additional project-related data sources throughout the Delphi technique. This included data from a patient focus group (patient co-design), patient survey, technical feasibility testing, 3 months of pilot testing (four sites), 3 months of national implementation (29 sites) and global evidence. This process ensured that staff and patient feedback was used to co-design the three iterations of the AusPROM recommendations until the final agreed version was established.
Results A total of 22 AusPROM recommendations were included in the final iteration. The recommendations covered the domains of PROM characteristics, healthcare organisation characteristics, external influences, staff and patient characteristics, and facilitators to implementing AusPROMS in routine practice.
Conclusion The AusPROM recommendations offer practical considerations for the implementation of PROMs in hospitals. The iterative nature of the Delphi technique ensured that staff and patient co-design were central to the development of the AusPROM recommendations.
Keywords: acceptability, co-design, consumer, Delphi technique, engagement, feasibility, implementation science, patient reported outcome measure (PROM), QoR-15, quality of recovery.
References
[1] Black N. Patient reported outcome measures could help transform healthcare. BMJ 2013; 346 f167| Patient reported outcome measures could help transform healthcare.Crossref | GoogleScholarGoogle Scholar |
[2] Bryan S, Davis J, Broesch J, et al. Choosing your partner for the PROM: a review of evidence on patient-reported outcome measures for use in primary and community care. Healthc Policy 2014; 10 38–51.
[3] van der Willik EM, Terwee CB, Bos WJW, et al. Patient‐reported outcome measures (PROMs): making sense of individual PROM scores and changes in PROM scores over time. Nephrology 2021; 26 391–399.
| Patient‐reported outcome measures (PROMs): making sense of individual PROM scores and changes in PROM scores over time.Crossref | GoogleScholarGoogle Scholar |
[4] Greenhalgh J, Gooding K, Gibbons E, et al. How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis. J Patient Rep Outcomes 2018; 2 42
| How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis.Crossref | GoogleScholarGoogle Scholar |
[5] Stover AM, Haverman L, van Oers HA, et al. Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings. Qual Life Res 2020; 30 3015–3033.
| Using an implementation science approach to implement and evaluate patient-reported outcome measures (PROM) initiatives in routine care settings.Crossref | GoogleScholarGoogle Scholar |
[6] Ahmed S, Zidarov D, Eilayyan O, et al. Prospective application of implementation science theories and frameworks to inform use of PROMs in routine clinical care within an integrated pain network. Qual Life Res 2020; 30 3035–3047.
| Prospective application of implementation science theories and frameworks to inform use of PROMs in routine clinical care within an integrated pain network.Crossref | GoogleScholarGoogle Scholar |
[7] Krogsgaard MR, Brodersen J, Christensen KB, et al. What is a PROM and why do we need it? Scand J Med Sci Sports 2020; 31 967–971.
| What is a PROM and why do we need it?Crossref | GoogleScholarGoogle Scholar |
[8] Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). FAOA PROMs Pilot Project Final Report. 2020. Available at https://aoanjrr.sahmri.com/documents/10180/681914/AOANJRR+PROMs+Pilot+Final+Report [accessed January 2021]
[9] Australian Orthopaedic Association. Australian Orthopaedic Association National Joint Replacement Registry Annual Report 2021. 2021. Available at https://aoa.org.au/docs/default-source/annual-reports---public/aoa-annual-report-2020-2021-public.pdf?sfvrsn=a5ddd404_10
[10] Agarwal A, Pain T, Levesque J-F, et al. Patient-reported outcome measures (PROMs) to guide clinical care: recommendations and challenges. Med J Aust 2022; 216 9–11.
| Patient-reported outcome measures (PROMs) to guide clinical care: recommendations and challenges.Crossref | GoogleScholarGoogle Scholar |
[11] Jünger S, Payne SA, Brine J, et al. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: recommendations based on a methodological systematic review. Palliat Med 2017; 31 684–706.
| Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: recommendations based on a methodological systematic review.Crossref | GoogleScholarGoogle Scholar |
[12] Brusco NK, Atkinson V, Woods J, Myles PS, Hodge A, Jones C, Lloyd D, Rovtar V, Clifford AM, Morris ME. Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability. J Patient‐Reported Outcomes 2022; 6 73
| Implementing PROMS for elective surgery patients: feasibility, response rate, degree of recovery and patient acceptability.Crossref | GoogleScholarGoogle Scholar |
[13] Morris ME, Atkinson V, Woods J, Myles PS, Hodge A, Jones CH, Lloyd D, Rotvar V, Clifford AM, Brusco NK. Patient Judgement of Change with Elective Surgery Correlates with Patient Reported Outcomes and Quality of Life. Healthcare 2022; 10 999
| Patient Judgement of Change with Elective Surgery Correlates with Patient Reported Outcomes and Quality of Life.Crossref | GoogleScholarGoogle Scholar |
[14] Stark PA, Myles PS, Burke JA. Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score: The QoR-15. Anesthesiology 2013; 118 1332–1340.
| Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score: The QoR-15.Crossref | GoogleScholarGoogle Scholar |
[15] Kleif J, Waage J, Christensen KB, et al. Systematic review of the QoR-15 score, a patient-reported outcome measure measuring quality of recovery after surgery and anaesthesia. Br J Anaesth 2018; 120 28–36.
| Systematic review of the QoR-15 score, a patient-reported outcome measure measuring quality of recovery after surgery and anaesthesia.Crossref | GoogleScholarGoogle Scholar |
[16] Keith RE, Crosson JC, O’Malley AS, et al. Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation. Implement Sci 2017; 12 15
| Using the Consolidated Framework for Implementation Research (CFIR) to produce actionable findings: a rapid-cycle evaluation approach to improving implementation.Crossref | GoogleScholarGoogle Scholar |
[17] Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci 2013; 8 139
| Implementation strategies: recommendations for specifying and reporting.Crossref | GoogleScholarGoogle Scholar |
[18] Sokas C, Hu F, Edelen M, et al. A Review of PROM Implementation in Surgical Practice. Ann Surg 2022; 275 85–90.
| A Review of PROM Implementation in Surgical Practice.Crossref | GoogleScholarGoogle Scholar |
