Abstract
Background/ObjectivesRoutine use of patient-reported outcome measures (PROMs) to assess quality of health care systems is mandated in many countries and has been implemented successfully in many specialities. Ophthalmology currently lags behind. To support and inform future implementation, we investigated paediatric ophthalmic clinicians’ experience of, and future training needs for, using child-appropriate vision PROMs and their views about the barriers and enablers to future routine implementation in clinical practice.MethodsWe conducted a pilot study, using an online survey to elicit the experience, attitudes, training needs and perceptions of barriers and enablers to routine PROMs use of ophthalmic health professionals in the Paediatric Ophthalmology Department at Great Ormond Street Hospital, London. A focus-group was undertaken to discuss survey results and preferences regarding presentation of PROM data. Analysis comprised descriptive statistics, presented alongside complementary qualitative data.ResultsEighteen clinicians in the department completed the survey. Twenty-seven took part in the focus group. Clinicians had limited experience of using PROMs but high confidence in the potential positive impact on communication with patients, monitoring chronic conditions and clinical decision-making. Clinicians identified operational issues (collection and analysis of data) and impact (interpretation and application of data) as the two key areas for consideration. Training and information requirements before implementation were clearly articulated, alongside the benefits of using digital/electronic data capture ahead of consultations to allow efficiency and automated analysis, and presentation in an appropriate visual format alongside clinical data to ensure meaningful use.ConclusionThe findings of this pilot study of ophthalmic clinicians working in a specialist paediatric ophthalmology department, suggest that ophthalmic clinicians recognise the potential benefits of routine PROMs use in clinical practice. Together with existing literature outside ophthalmology relating to overcoming barriers and exploiting enablers to routine implementation, findings may be applicable in planning routine PROM implementation in paediatric ophthalmology.
Highlights
High quality healthcare has three domains: safety, effectiveness and positive patient experience [1, 2]
Allow efficiency and automated analysis, and presentation in an appropriate visual format alongside clinical data to ensure meaningful use. The findings of this pilot study of ophthalmic clinicians working in a specialist paediatric ophthalmology department, suggest that ophthalmic clinicians recognise the potential benefits of routine Patient-reported outcome measures (PROMs) use in clinical practice
Together with existing literature outside ophthalmology relating to overcoming barriers and exploiting enablers to routine implementation, findings may be applicable in planning routine PROM implementation in paediatric ophthalmology
Summary
High quality healthcare has three domains: safety, effectiveness and positive patient experience [1, 2]. Routine use of PROMs is widely advocated [3,4,5] and has been used to assess and improve the quality of healthcare in many countries [6]. In the UK National Health Service (NHS), routine PROM use was initially mandated for four high volume ‘beacon’ surgical procedures in adults with the expectation that improved subjective well-being would reflect high quality care [7]. Routine use of PROMs to measure the quality of ophthalmic health services is not mandated. In the context of chronic conditions, promoting health-related quality of life becomes an important focus of healthcare [8]
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