Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)

Health Services Research

Measurement

IC11: Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice

Presenter(s)

• 

  Sara Ahmed, PhD, PT

  Associate Professor
  McGill University
  Montreal, Quebec

  Presentation Slides
• 

  Zachary Boychuck, PhD, OT

  Postdoctoral Fellow, Faculty Lecturer
  McGill University, School of Physical and Occupational Therapy
  Montreal, Quebec
• 

  Emily Evans, PhD, PT

  Postdoctoral Research Fellow
  Brown University
  Salem, Massachusetts

  Presentation Slides Presentation + Audio
• 

  Richard Gershon, PhD

  Professor
  Northwestern University - MSS
  Chicago, Illinois

  Presentation Slides
• 

  Namrata Grampurohit, PhD, OTR/L

  Assistant Professor
  Thomas Jefferson University
  Philadelphia, Pennsylvania

  Presentation Slides
• 

  Ann Guernon, M.S.,CCC-SLP

  Clinical Research Manager/Coordinator
  Marianjoy Rehabilitation Hospital
  SUGAR GROVE, Illinois

  Presentation Slides
• 

  Piper Hansen, OTD, OTR/L, BCPR

  Clinical Assistant Professor and Academic Fieldwork Coordinator
  University of Illinois at Chicago, College of Applied Health Sciences
  Chicago, Illinois
• 

  Kristen Maisano, OTD, OTR/L

  Associate Professor
  St. Catherine University
  Alexandria, Virginia
• 

  Julie Schwertfeger, PhD

  Assistant Professor
  Rosalind Franklin University of Medicine & Science
  North Chicago, Illinois

  Presentation Slides Presentation + Audio
• 

  David Tulsky, PhD

  Professor
  University of Delaware
  Newark, Delaware
• 

  Jennifer Weaver, MA, OTR/L, CBIS

  Research Associate
  The George Washington University
  Washington, District of Columbia

  Presentation Slides

Body of Abstract: Outcomes that can only be assessed by the person are referred to as patient-reported outcomes (PROs). PROs complement clinical and biomedical outcomes by helping to understand the patient experience of living with disease including understanding physical, emotional, social functioning, and trade-offs and demands related to the treatment regimens or programs.



With a shift towards patient-centered care, where the needs of the patient and family and their active involvement is central to guiding treatment decisions, PROs are increasingly being integrated into clinical care. Successfully integrating PROs into clinical practice requires defining objectives for collecting PROs and systematically identifying barriers and enablers to implementing PROs to tailor strategies for applying PROs in clinical practice.



The course will provide an introduction to the use of PROs in clinical practice and for quality improvement along with an overview of implementation science principles and how they can facilitate the use of PROs. To increase their widespread adoption and to optimize their usefulness to a range of stakeholders, PRO measures must be perceived as relevant, meaningful, and actionable to the patients, the clinicians using them, and the organizations implementing them. Application of the principles from implementation science can help identify strategies that address the contextual barriers and facilitators to using PRO measures in a specific clinical context. They can also guide the selection of implementation strategies and evaluate if the implementation of PRO measures was effective in improving the desired outcomes (e.g. patient activation, achieving rehabilitation goals). Participants will benefit from the experience of ongoing initiatives and from information exchange between participants using a structured and interactive approach.



Target audience: The course is intended for clinicians, but also intended for any person familiar with basic knowledge of PROs and with an interest in their use for enhancing clinical practice. Participants are likely to benefit from mutual exchange if they already have some experience in the area, although this is not a pre-requisite. Ahead of the course, registered participants will be asked about specific questions they would like to see addressed in the course and about their level of knowledge in the area to refine and tailor the course content. Participants will also receive preparatory reading materials in advance of the course.



Specific Learning Objectives include:

• Describe the value of PROs relative to other types of outcome measures for clinical practice and research

• Describe examples of PRO measures, including the PROMIS measurement system, and strategies to select the most appropriate patient-reported outcome domains for clinical practice and research

• Describe implementation science principles and how they can be used to identify enablers and barriers for implementing PRO measures in clinical practice

• Describe how implementation science frameworks can guide the evaluation of the process and effectiveness of using PROMs in clinical practice

• Apply knowledge of implementation science to the integration of PROMs into clinical practice based on case study examples and small group discussions focused on the participant’s own setting.

Course Outline

• Measuring what matters: Introduction to PRO measures and their use in rehabilitation clinical practice and quality improvement – Sara Ahmed

• A review of PRO measures used in rehabilitation clinical practice and research and guidelines for implementing PROs - Sara Ahmed

• PROMIS and NeuroQoL measurement system – Richard Gershon

• Implementation Science theories and frameworks appropriate for clinical practice – Jennifer Weaver & Kristen Maisano

• Common implementation Science strategies/research designs - Jennifer Weaver & Kristen Maisano

• Implementation of PROs for in-patient and out-patient care and quality improvement and examples of initiatives aimed at the widespread use of PROs in clinical practice - Julie Schwertfeger & Emily Evans

• Case study 1: Implementing PROs in an integrated chronic pain network Zachary Boychuck

• Case study 2: Implementation of PROs in TBI – Ann Guernon

• Case study 3: Implementation of PROs in a telehealth Early Assisted Discharge Post-Stroke program – Zachary Boychuck

• Case study 4: Interpretability of scores, and linking assessments to web-based spinal cord injury self-management skills training – David Tulsky

• Small group discussion: Participants can use their settings to work through a structured exercise to identify barriers and enablers and develop an implementation plan. Report back to the larger group (Namrata Grampurohit + Piper Hansen)

• Concluding remarks (All)

Abbreviated Description: An introductory course will be presented on implementation science and the integration of patient-reported outcomes (PRO) into clinical practice. Attendees will be introduced to guidelines that can be used to direct PRO use for patient care and quality improvement. Participants will learn about implementation science principles and how they can help identify strategies that address the contextual barriers and facilitators to using PRO measures in a specific clinical context. The course learning objectives will also target the evaluation of the implementation process and the effectiveness of using PRO measures for desired outcomes such as patient activation or goal achievement. Participants will benefit from ongoing initiatives and information exchange between participants using a structured and interactive approach. The course is intended for clinicians, but also for anyone with introductory knowledge of PROs and an interest in their use for enhancing clinical practice.

Learning Objectives:

• • Describe the value of patient-reported outcomes (PROs) relative to other types of outcome measures for clinical practice and research
• • Describe examples of PRO measures, including the PROMIS measurement system, and strategies to select the most appropriate patient-reported outcome domains for clinical practice and research
• • Describe implementation science principles and how they can be used to identify enablers and barriers for implementing PRO measures in clinical practice
• • Describe how implementation science frameworks can guide the evaluation of the process and effectiveness of using PROMs in clinical practice
• • Apply knowledge of implementation science to the integration of PROMs into clinical practice based on case study examples, and small group discussions focused on the participant’s own setting.

Presentations:

• 8:30 AM – 9:00 AM EST

  IC11: Measuring what Matters: Introduction to PRO measures and their use in rehabilitation clinical practice and quality improvement (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 9:00 AM – 9:30 AM EST

  IC11: Introduction to PROMIS and Neuro-Qol (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 9:30 AM – 9:45 AM EST

  IC11: Expanding PROMIS and NeuroQoL Item Banks: SCI and TBI QoL (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 10:15 AM – 11:15 AM EST

  IC11: Implementation Science Theories & Frameworks Appropriate for Clinical Practice (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 11:15 AM – 11:45 AM EST

  IC11: Drivers Facilitating PRO Use in Systems of Care (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 12:00 PM – 1:00 PM EST

  IC11: Group Activity (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 2:00 PM – 2:25 PM EST

  IC11: Case Study 1: Implementing PROs in an Integrated Chronic Pain Network (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 2:25 PM – 2:50 PM EST

  IC11: Case Study 2: Implementation of PROs in TBI
• 3:00 PM – 3:25 PM EST

  IC11: Case Study 3: Implementation of PROs in a tele-health Early Supported Discharge (ESD) Post-Stroke Program (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 3:25 PM – 3:50 PM EST

  IC11: Case Study 4: Interpretability of scores, and linking assessments to web-based spinal cord injury self-management skills training (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 4:15 PM – 4:30 PM EST

  IC11: Wrap-Up & Summary (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)
• 4:30 PM – 5:30 PM EST

  IC11: Group Activity (Integrating Patient Reported Outcomes (PRO) in Rehabilitation Clinical Practice)