Okay, you’re already using patient-reported outcome measures (PROMs) questionnaires in your clinic, right? After all, you know that PROMs are key to improving patient safety, fostering the delivery of patient-centered care, and getting paid what you deserve in the new pay-for-performance healthcare model. But even if you’ve been using these tools for years now, you may not be getting the most out of them. Let’s fix that today. Here are the dos and don’ts of PROMs:
Do Communicate the Benefits. Don’t Overpromise.
As Brooke Andrus explains in this post, for any outcomes-tracking effort to work, everyone in the clinic has to be on board. To accomplish that, you must be able to communicate the benefits of outcomes tracking to your staff. Beyond filling your team in on the benefits I mentioned in the introduction, Andrus suggests telling your staff why your practice—and they as individual therapists—“can’t afford not to track this information.” That means you’ve got to “explain the changing payment and regulatory landscape—and how it’s going to affect the rehab therapy industry in the coming months and years,” Andrus said. "Rally [your team] around the idea of providing the best care possible—and explain why that’s not possible unless everyone tracks their results. Because to identify meaningful trends—and apply that information to ensure optimal treatment and care—you’re going to need all hands on deck.”
The flipside of that, though, is that you must be careful not to overpromise. As Charlotte Bohnett advises in this article, “Be honest with your staff—there may be an adjustment period, a learning curve, and some time devoted to education.” While she’s talking about pitching an EMR, that tip holds true for pitching outcomes tracking, too.
Do Educate. Don’t Influence.
Andrus also explains that for patient-reported outcomes data to mean anything at all, your patients must actually complete them—and they must do so honestly. The only way to encourage your patients to give these tests the time and attention they deserve, is to give your patients the time and attention they deserve—and by that, I mean educate them about the tests (but don’t influence their answers). Andrus recommends ensuring every patient understands:
- “How to complete the questionnaire,
- How you plan to use his or her responses, and
- How participating benefits them.”
Instead of handing patients the questionnaire without preamble—or worse yet, handing them the questionnaire and then watching them fill it out, which can inadvertently skew their responses—teach patients the importance of these tests and then leave them to complete them on their own. After all, you want your patients to answer the questions in whatever way best represents their current functional abilities—not how you feel their functional abilities stack up, and certainly not how they think you want them to answer. That being said, it’s a good idea to make sure you—or someone else in your clinic—is available should your patients have practical questions about completing the questionnaire. Then, when you review the results of the PROM—preferably with your patient, as that helps keep him or her engaged in the care process—keep your statements empathetic and neutral. After all, you want patients to feel comfortable being honest with you about their progression.
It can also be beneficial to include an intro paragraph at the top of the questionnaire itself. Check out Andrus’s post to see an example.
Do Set Expectations. Don’t Micromanage.
This one applies to both patients and staff members. For staffers, Andrus recommends delegating specific outcomes process responsibilities to each member of your team. After all, it’s “a clinic-wide initiative”—and that means everyone’s going to need to run point on at least one part of the workflow, whether that’s test administration, results entry, analysis, or follow-up.
In this post, Lauren Milligan says it can also be beneficial to set an outcomes testing schedule that ensures “you’re collecting valuable information at relevant points in the treatment process without inundating the patient—or yourself—with unnecessary forms.” In other words, “don’t administer OMTs at every visit. Do complete them on a schedule that makes sense, and always perform an outcomes assessment at discharge or at the conclusion of treatment so you and the patient are able to quantify the improvement that’s been made.” This type of schedule will help ensure you set clear expectations, so you, your staff, and your patients are all on the same page—no micromanagement required.
Speaking of setting clear patient expectations, if you have numerous patients who regularly discontinue therapy before their treatment is over—or come to their sessions without having completed their home exercises—you may have some work to do. “It’s not enough to provide patients with information about treatment decisions at the beginning of care and then assume that they’ll stay committed to the plan,” Milligan said. “Therapists also must set the expectation that therapy works when and if the patient remains actively involved throughout the entire recovery process.” She goes on to explain that “patients should not only understand their treatment options, but also know what they need to contribute to the process and what outcomes they should expect. That way, everyone understands the goal and how to reach it”—and you won’t have to continually prod your patients to do the work.
There you have it: the dos and don’ts of PROMs. Have any strategies of your own? Share them in the comment section.