Implementation of Patient Reported Measures (PRMs) across NNSWLHD across 2021, has been extremely successful with all scheduled services achieving implementation of both Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs).
PRMs commenced roll-out across NNSWLHD in March targeting the Leading Better Value Care (LBVC) Tranche 1 initiatives. Locally, NNSWLHD approach was to implement only in the Community Health setting.
The phased roll out included the following LHD services:
- Renal Supportive Care (RSC)
- Chronic Obstructive Pulmonary Disease (COPD)
- Knee & Hip Arthritis Services (KAHAS)
- Chronic Heart Failure (CHF)
- Osteoporosis Refracture Prevention (ORP)
- Diabetes Services (DM)
- High Risk Foot Services (HRFS)
The ACI built an IT platform for collection of PRMs called HOPE (Health Outcomes and Patient Experience). Clinicians were trained to use this platform to allocate PRMs to patients, use the completed PRM in real time and then work with the patient to plan care.
Rebecca Davey, LBVC Manager said “The implementation of this significant change in practice is a major achievement for managers, clinicians, patients and the PRM team, particularly whilst directly competing with the challenges that Covid-19 placed on service delivery.”
NNSWLHD PRM activity 2021
By the end of 2021, there will be 34 services having implemented PRMs across NNSWLHD. 3 remaining services within the LBVC initiatives, are ready for go live in the HOPE system and will be scheduled in 2022.
NNSWLHD data as of the 14th of December is as follows:
- NNSWLHD clinicians trained and using HOPE = 67
- Patients consented to receiving PRMs = 1,842
- PROMs completed = 3,578
- PREM’s (experience measures) completed = 80
Table below indicates PROM’s completion by each service:
Patient feedback has been positive, with the following responses as some examples:
“As someone who struggled with depression, I can really see the value in being able to openly discuss normally difficult topics with clinicians using the surveys.”
“Being a private person, it is easier for me to do this survey because I don’t feel watched or don’t feel pressurised in a busy environment.”
Clinician feedback has also been positive:
“Being able to send surveys prior to appointment times allows me to spend more time with the patient and discuss their responses and concerns in more depth.”
“It’s highlighted how often as a clinician you “presume” something about a patient.”
“It got family members involved in the care of their loved ones.”
Clinicians have also provided good feedback through a locally created QARS survey about the PRM/ HOPE education/ training meeting their needs.
Planning for 2022
The PRMs team has outlined the implementation plan for January to June 2022. The Agency for Clinical Innovation (ACI) advises to remain within the LBVC and Integrated Care cohorts, to align with endorsed surveys already available in HOPE.
The following services are planned for implementation in 2022:
- Wound clinics – Tweed, Pottsville, Murwillumbah, Byron, Ballina and Casino
- Paediatric clinics (Outpatient and Community Health) – Tweed, Lismore, Grafton
- Paediatric Inpatient units – Tweed, Lismore, Grafton
- Inpatient Rehabilitation Unit – Maclean
Engagement and consultation with these managers and services has occurred and there is support and agreement to implement in 2022. The PRM team are currently mapping services, identifying staffing numbers, workflows and education needs for each area.
Next steps also include proposing NNSWLHD governance structure for PRMs. Service managers will eventually be able to access reports from HOPE. As the data is ‘real time’ both services and the LHD will benefit from the ability to monitor progress and outcomes immediately.
It has been a successful 2021 for services, clinicians and patients in implementing PRMs across NNSWLHD. The PRM team have learned a great deal, been received well by all and are approaching 2022 with a great deal of optimism.