scholarly journals 82 Person-Centred Emergency Care Outcome Measurement For Older People Living with Frailty

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
J van Oppen
Keyword(s):  
Health Outcome ◽  
Emergency Care ◽  
Outcome Measurement ◽  
Field Testing ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Structured Interviews ◽  
Outcome Goals ◽  
Outcome Framework ◽  
Patient Reported

Abstract Introduction Health outcome goals are the results individuals seek from healthcare. These may incorporate holistic themes including function, mood, and quality of life. People living with frailty have poorer outcomes from even short hospital stays. They benefit from person-centred, goal-directed care over protocol-driven pathway approaches. This could be improved by monitoring attainment of health outcome goals. Methods A systematic review for older people’s health outcome goals in emergency care was conducted using narrative synthesis. A qualitative study based on grounded theory expanded the outcome framework to include people living with frailty. People with cognitive and communication barriers were included in semi-structured interviews. Discussions focussed on the events and outcomes sought from emergency care. Results Older people’s health outcome goals for emergency care were classified as efficient and comprehensive care, sensitivity towards vulnerability, and person-centred informed care. The importance of understanding individual perceptions was explicit. Research generally recruited based on age rather than physiological and functional state, and did not assess for impact of frailty on healthcare perceptions. The interview study was paused due to the COVID-19 pandemic. Initial results showed a predominance of person-centred and holistic care themes among health outcome goals. Participants’ most common goal for emergency care was relief of symptoms: people often had pain. Participants mostly had severe frailty and wanted their mobility to be assessed, with goals of recovering their functional baseline. While participants had confidence in healthcare professionals and were generally willing to “do as we are told to feel better”, they expected to undergo at least basic tests in order to receive a working diagnosis for their problem. People wanted to understand their illness and for explanations to be communicated to their relatives. Next steps Patient-reported outcome measures (PROMs) for this range of emergency care outcomes are being identified for field-testing in acute settings.

Optimizing electronic capture of patient-reported outcome measures in oncology clinical trials: lessons learned from a qualitative study

2020 ◽  
Vol 9 (17) ◽  
pp. 1195-1204
Author(s):  
Florence D Mowlem ◽  
Brad Sanderson ◽  
Jill V Platko ◽  
Bill Byrom
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Lessons Learned ◽  
Structured Interviews ◽  
Patient Reported ◽  
Oncology Clinical Trials ◽  
Anticancer Treatment ◽  
Fit For Purpose ◽  
The Impact ◽  
Electronic Implementation

Aim: To understand the impact of anticancer treatment on oncology patients’ ability to use electronic solutions for completing patient-reported outcomes (ePRO). Materials & methods: Semi-structured interviews were conducted with seven individuals who had experienced a cancer diagnosis and treatment. Results: Participants reported that the following would impact the ability to interact with an ePRO solution: peripheral neuropathy of the hands (4/7), fatigue and/or concentration and memory issues (6/7), where they are in a treatment cycle (5/7). Approaches to improve usability included: larger, well-spaced buttons to deal with finger numbness, the ability to pause a survey and complete at a later point and presenting the recall period with every question to reduce reliance on memory. Conclusion: Symptoms associated with cancers and anticancer treatments can impact the use of technologies. The recommendations for optimizing the electronic implementation of patient-reported outcome instruments in this population provides the potential to improve data quality in oncology trials and places patient needs at the forefront to ensure ‘fit-for-purpose’ solutions.

scholarly journals Patient-Reported Outcomes Measures: An Introduction for Clinicians

2019 ◽  
Vol 4 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Kathryn Yorkston ◽  
Carolyn Baylor
Keyword(s):  
Instrument Development ◽  
Patient Reported Outcomes ◽  
Outcome Measurement ◽  
Communication Disorders ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Outcomes Measures ◽  
Patient Reported ◽  
Measurement Tools

Patient-reported outcome measures contain information that comes directly from the patient without interpretation by anyone else. These measures are an important part of a clinicians' arsenal of assessment approaches and are critical in the development of patient-centered approaches to intervention. In this introduction to patient-reported outcome measurement tools, a history is provided of this approach to measurement and its place within the context of clinical research and practice. The process of instrument development and application will be reviewed, along with examples of measurement tools from the field of neurological communication disorders. This introduction is supplemented by references that provide interested readers with more detailed information.

Measuring psychological outcomes in paediatric settings: Making outcomes meaningful using client-defined perspectives

2020 ◽  
Vol 25 (3) ◽  
pp. 594-603
Author(s):  
Halina Flannery ◽  
Jenna Jacob
Keyword(s):  
Young People ◽  
Outcome Measures ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Psychological Outcome ◽  
Chronic Health ◽  
Patient Reported

There is a growing drive to develop and implement patient-reported outcome measures within paediatric health services, particularly for young people living with chronic health conditions; however, there is little consensus on how best to do this in meaningful ways within psychological services working alongside medical teams. This reflective commentary considers some of the challenges of collecting psychological outcome measures in paediatric services and considers alternative approaches to making outcome measurement meaningful. All measures have their limitations; however, they become meaningless if they are not used in meaningful and considered ways with young people. Client-defined outcome measurement, such as goal-based outcome measures, alongside other types of measurement, can capture outcomes of meaning to young people living with chronic health conditions, and can enable them to feed into a shared decision-making process.

scholarly journals Getting the measure of outcomes in clinical practice

2014 ◽  
Vol 20 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Glyn Lewis ◽  
Helen Killaspy
Keyword(s):  
Outcome Measures ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Quality Of Services ◽  
List Type ◽  
Regression To The Mean ◽  
Process Measures ◽  
Patient Reported

SummaryIt has been argued that the routine use of patient-reported outcome measures (PROMs) should be encouraged in order to improve the quality of services and even to determine payment. Clinician-rated outcome measures (CROMs), patient-reported experience measures (PREMs) and process measures also should be considered in evaluating healthcare quality. We discuss difficulties that the routine use of outcome measures might pose for psychiatric services. When outcome and experience measures are used to evaluate services they are difficult to interpret because of differences in case mix and regression to the mean. We conclude that PROMs and CROMs could be useful for monitoring the progress of individuals and that clinical audit still has an important role to play in improving the quality of services.LEARNING OBJECTIVESUnderstand the difference between process measurement and outcome measurement.Understand the limitation of using outcome measures to assess and promote quality of services.Understand the difficulties in assessing the psychometric properties and validity of outcome measures.

Patient Reported Outcome Measures in Neurologic Communication Disorders: An Update

2015 ◽  
Vol 25 (3) ◽  
pp. 114-120 ◽  
Author(s):  
Michael de Riesthal ◽  
Katherine B. Ross
Keyword(s):  
Clinical Practice ◽  
Outcomes Research ◽  
Outcome Measurement ◽  
Communication Disorders ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Rehabilitation Outcomes ◽  
Patient Reported ◽  
Centered Care

In her seminal book on outcome measurement in the field of communication disorders, Carol Frattali (1998) set the path for outcomes research and clinical application in the field of speech-language pathology. In particular, she defined the many possible outcomes that can be measured to examine the influence of an intervention and the ways in which these measures can inform public policy. Of these, patient or client centered measures, which index outcome based on the patient's and family's or caregiver's perspective, have received increasing attention in recent research and clinical practice. These measures examine a variety of patient reported outcomes (PRO) associated with health. PRO measures are being used more commonly in clinical practice and as end points in medical and rehabilitation outcomes research. This perspective reflects the shift in medicine and rehabilitation toward patient-centered care. In this article, we will examine the rationale for using PRO measures, the advantages and challenges for using these tools, and current use of PRO measures in neurological communication disorders.

scholarly journals The use of patient-reported outcome measures in primary care: applications, benefits and challenges

2021 ◽  
Vol 5 (S2) ◽  
Author(s):  
Krista Brower ◽  
Margo Schmitt-Boshnick ◽  
Michel Haener ◽  
Shea Wilks ◽  
Allison Soprovich
Keyword(s):  
Primary Care ◽  
Outcome Measurement ◽  
Local Population ◽  
Target Population ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Full Potential ◽  
System Quality ◽  
Allied Health Professionals ◽  
Patient Reported

AbstractPROMs use in primary care has expanded from simply describing patient populations to contributing to decision-making, in response to the increasingly complex, ever-changing healthcare environment. In Alberta, primary care is organized into primary care networks (PCNs), where family physicians are grouped geographically and supported by allied health professionals. PCNs implement programs and services in response to local population health needs with frequent evaluation, often incorporating PROMs for this purpose. As PCN programs and services vary greatly across Alberta, so do their use of PROMs. An area of commonality is the use of the EQ-5D-5L instrument; 29 out of 41 PCNs are registered and licensed to use the instrument. It is often administrated by paper, pre- and post-program, and in combination with other specific measures, depending on the program or target population. Some PCNs share programming and therefore outcome measurement, but often the selection, implementation (including training and administration procedures) and evaluation/reporting of PROMs are unique to the PCN. As well, data analysis is largely dependent on the size and capacity of the PCN. Using PROMs for PCN program evaluation supports clinical understanding and complements clinical outcomes. PROMs describe the population attending a program, as well as provide an element of consistency when examining trends across multiple programs or timepoints. This contributes to inquiries and decisions around program development, components, administrative features, resource allocation and delivery. Challenges of PROMs use in primary care include the absence of cohesive data capture technology. This limits data capabilities and presents difficulties with data fidelity, storage, export, and analysis. Additionally, this real-world application lacks a control arm and presents methodological challenges for comparative research purposes. Furthermore, capturing long term patient outcomes poses administrative challenges of multiple follow ups. More research is required into best reporting mechanisms to ensure the data is used to its full potential. To overcome these challenges, leadership and clinician engagement are key. As well, determining consistent PCN PROM reporting requirements will ensure data are comparable across PCNs and contribute to provincial level evaluations, further supporting the movement towards overall health system quality improvement.

scholarly journals Outcome measurement in trauma surgery with a fracture database and clinical and patient-reported outcome measures (PROMs)

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
M Bilici ◽  
M Morgenstern ◽  
C Frank ◽  
N Alispahic ◽  
A Müller ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Role Model ◽  
Query Language ◽  
Outcome Measurement ◽  
Trauma Surgery ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Inclusion Criteria ◽  
Patient Reported ◽  
The Usa

Abstract Objective Patient-Reported Outcome Measures (PROMs) gain growing attention. The Food and Drug Administration suggested in 2009 to have PROMs for every new treatment and technology. The use of PROMs was further promoted by the Patient Protection and Affordable Care Act of 2010 in the USA. Recommendations from other national and international organizations include the OECD's Project of Patient-Reported Indicator Surveys (PaRIS) and the International Consortium for Health Outcomes Measurement (ICHOM). Our development and initiation of a Fracture Database started early in 2018. We orientated our database on the role model of the Swedish Fracture Registry. Methods REDCap (Research Electronic Data Capture) is a web interface for a SQL (Structured Query Language)-Database. We used it to program the Fracture Registry. We collect data about demographics, diagnosis, treatment, adverse events, clinical outcomes, and PROMs. The PROMS are recorded with the Software 'Heartbeat ONE' vs. 6.15.4. Inclusion criteria are all patients with fractures of the upper and lower extremity, including the pelvis and multiple injuries, treated surgically. Excluded are all patients with fractures of the hand as monotrauma and non-surgical treatment. We established questionnaire sets for each anatomical region. Every hospitalized patient is screened for inclusion criteria to get the baseline PROMs. Follow-up PROMs are collected at 3-months and 12-months in our outpatient clinic. Results In five months of collecting PROMs, we have evaluated 599 patients, 521 fulfilling the inclusion criteria. 329 (63%) questionnaire sets were completed. The mean time for answering the questions was 11-20 minutes. The input rate of 63% for PROMs accounts for the start of the process, with 22 (4%) patients being dismissed before answering the questionnaires. 93 (18%) patients denied participation. 52 (10%) patients were not able to participate (dementia, delirium). Other causes for missing data were language barriers (n = 28; 5%), medical reasons like polytraumatized patients (n = 4; 0.8%), and deceased patients (n = 15; 2.9%). Conclusion Most Orthopaedic Trauma centers publish data about PROMs from surgically treated patients. Starting in the first quarter of 2021, we will include non-surgically treated patients. We have optimized the process of including patients. Our aim is a response rate of more than 80% within this year to get representing data.

Patient reported outcome measures (PROMs) for goalsetting and outcome measurement in primary care physiotherapy, an explorative field study

Physiotherapy ◽  
2017 ◽  
Vol 103 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Simone A. van Dulmen ◽  
Philip J. van der Wees ◽  
J. Bart Staal ◽  
J.C.C. Braspenning ◽  
Maria W.G. Nijhuis-van der Sanden
Keyword(s):  
Primary Care ◽  
Field Study ◽  
Outcome Measures ◽  
Outcome Measurement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported
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