Moving towards patient-reported outcomes in routine clinical practice: Implementation lessons from the BREAST-Q Journal Article
| Authors: | Nelson, J. A.; Chu, J. J.; Dabic, S.; Kenworthy, E. O.; Shamsunder, M. G.; McCarthy, C. M.; Mehrara, B. J.; Pusic, A. L. |
| Article Title: | Moving towards patient-reported outcomes in routine clinical practice: Implementation lessons from the BREAST-Q |
| Abstract: | PurposeLongitudinal, routine utilization of patient-reported outcome measures (PROMs) in clinical care has been challenging. The purpose of this study is to describe a quality improvement initiative to improve patient engagement with the BREAST-Q, a gold-standard PROM for breast reconstruction.MethodsIn 2011, we implemented the BREAST-Q as part of routine care. In 2018, we began a quality improvement initiative to increase BREAST-Q patient participation. The BREAST-Q was administered at every clinic visit via an institutional patient portal or an in-clinic tablet; digital dashboard technologies were used to improve workflow integration, real-time accountability, and immediate data availability at clinic visits. High clinical staff engagement was encouraged by assigning "BREAST-Q Champions." BREAST-Q completion data and patient characteristics were examined to understand non-response to the assessment.ResultsFollowing quality improvement, the average annual BREAST-Q completion rate increased from 42.8% in 2011-2017 to 87.6% in 2019, the last full year of our study period. High completion rates were maintained January-July 2020; however, a significantly larger proportion of BREAST-Qs were completed at home in 2020 versus the same period in 2019 (49.7 vs. 38.8%, p < 0.001), potentially due to the COVID-19 pandemic. Compared with non-responders, responders were younger (49.7 vs. 52.2 years, p < 0.001), more likely to be white (76.9 vs. 73.6%, p < 0.001), and had private insurance (79.4 vs. 69.8%, p < 0.001).ConclusionOur quality improvement initiative successfully increased routine completion of the BREAST-Q. Similar implementation techniques may prove beneficial at other institutions interested in incorporating PROMs into routine care. (PsycInfo Database Record (c) 2022 APA, all rights reserved) |
| Keywords: | clinical practice; patient-reported outcome measures; response rate; breast-q; non-responder |
| Journal Title: | Quality of Life Research |
| Volume: | 32 |
| Issue: | 1 |
| ISSN: | 0962-9343 |
| Publisher: | Springer |
| Date Published: | 2023-01-01 |
| Start Page: | 115 |
| End Page: | 125 |
| ACCESSION: | 2022-92801-001 |
| DOI: | 10.1007/s11136-022-03213-z |
| PROVIDER: | Ovid Technologies |
| PROVIDER: | psycinfo |
| PMCID: | PMC9380681 |
| PUBMED: | 35972615 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Jonas A. Nelson -- Source: APA PsycInfo |
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