Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective
Abstract Background Patient-reported outcome (PRO)-based follow-up is a new model of service delivery, where PRO measures are used as the very basis for demand-driven outpatient follow-up in patients with chronic diseases. Adopting the clinicians’ perspective, we aimed to explore what happens when P...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3352-y |
| _version_ | 1818134627373547520 |
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| author | Caroline Trillingsgaard Mejdahl Liv Marit Valen Schougaard Niels Henrik Hjollund Erik Riiskjær Kirsten Lomborg |
| author_facet | Caroline Trillingsgaard Mejdahl Liv Marit Valen Schougaard Niels Henrik Hjollund Erik Riiskjær Kirsten Lomborg |
| author_sort | Caroline Trillingsgaard Mejdahl |
| collection | DOAJ |
| description | Abstract Background Patient-reported outcome (PRO)-based follow-up is a new model of service delivery, where PRO measures are used as the very basis for demand-driven outpatient follow-up in patients with chronic diseases. Adopting the clinicians’ perspective, we aimed to explore what happens when PRO-based follow-up is implemented in routine clinical practice. We also aimed to identify organisational mechanisms related to PRO-based follow-up. Methods The methodological approach of this interview study is interpretive description, informed by a perspective of critical realism. Semi-structured interviews were conducted with 13 clinicians (eight nurses and five physicians) working with PRO-based follow-up in outpatient care for epilepsy in the Central Denmark Region. Results PRO-based follow-up gave rise to ambivalence in clinicians. Seen from the clinicians’ perspective, PRO-based follow-up could both increase and decrease the quality of follow-up. Moreover, PRO-based follow-up both enhanced and impaired clinicians’ work experiences. Additionally, the clinicians used strategies to ease some of the perceived disadvantages. The clinicians did extra tasks and worked around the scope of PRO-based follow-up. Thus, clinicians constituted a professional buffer as they deflected some of the negative mechanisms associated with PRO-based follow-up. Conclusions As a model of a service delivery, PRO-based follow-up is highly dependent on the clinicians’ day-to-day management of the system, and mechanisms related to routine use of PRO measures in outpatient follow-up are complex. Paying attention to the organisational settings is critical for PRO-based follow-up to improve quality of care and enhance patient-centred care. |
| first_indexed | 2024-12-11T09:11:37Z |
| format | Article |
| id | doaj.art-a76408aa268a4871b66f756e2c542f55 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T09:11:37Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-a76408aa268a4871b66f756e2c542f552022-12-22T01:13:29ZengBMCBMC Health Services Research1472-69632018-07-0118111210.1186/s12913-018-3352-yExploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspectiveCaroline Trillingsgaard Mejdahl0Liv Marit Valen Schougaard1Niels Henrik Hjollund2Erik Riiskjær3Kirsten Lomborg4Department of Public Health, Aarhus UniversityWestChronic, Occupational Medicine, University Research Clinic, Aarhus UniversityWestChronic, Occupational Medicine, University Research Clinic, Aarhus UniversityDEFACTUM, Social & Health Services and Labour Market, Central Denmark RegionThe Research Program in Patient Involvement, Aarhus University HospitalAbstract Background Patient-reported outcome (PRO)-based follow-up is a new model of service delivery, where PRO measures are used as the very basis for demand-driven outpatient follow-up in patients with chronic diseases. Adopting the clinicians’ perspective, we aimed to explore what happens when PRO-based follow-up is implemented in routine clinical practice. We also aimed to identify organisational mechanisms related to PRO-based follow-up. Methods The methodological approach of this interview study is interpretive description, informed by a perspective of critical realism. Semi-structured interviews were conducted with 13 clinicians (eight nurses and five physicians) working with PRO-based follow-up in outpatient care for epilepsy in the Central Denmark Region. Results PRO-based follow-up gave rise to ambivalence in clinicians. Seen from the clinicians’ perspective, PRO-based follow-up could both increase and decrease the quality of follow-up. Moreover, PRO-based follow-up both enhanced and impaired clinicians’ work experiences. Additionally, the clinicians used strategies to ease some of the perceived disadvantages. The clinicians did extra tasks and worked around the scope of PRO-based follow-up. Thus, clinicians constituted a professional buffer as they deflected some of the negative mechanisms associated with PRO-based follow-up. Conclusions As a model of a service delivery, PRO-based follow-up is highly dependent on the clinicians’ day-to-day management of the system, and mechanisms related to routine use of PRO measures in outpatient follow-up are complex. Paying attention to the organisational settings is critical for PRO-based follow-up to improve quality of care and enhance patient-centred care.http://link.springer.com/article/10.1186/s12913-018-3352-yPatient-reported outcome (PRO) measuresOutpatient follow-upQualitative researchInterpretive descriptionOrganisational mechanismsCustomisation |
| spellingShingle | Caroline Trillingsgaard Mejdahl Liv Marit Valen Schougaard Niels Henrik Hjollund Erik Riiskjær Kirsten Lomborg Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective BMC Health Services Research Patient-reported outcome (PRO) measures Outpatient follow-up Qualitative research Interpretive description Organisational mechanisms Customisation |
| title | Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective |
| title_full | Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective |
| title_fullStr | Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective |
| title_full_unstemmed | Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective |
| title_short | Exploring organisational mechanisms in PRO-based follow-up in routine outpatient care - an interpretive description of the clinician perspective |
| title_sort | exploring organisational mechanisms in pro based follow up in routine outpatient care an interpretive description of the clinician perspective |
| topic | Patient-reported outcome (PRO) measures Outpatient follow-up Qualitative research Interpretive description Organisational mechanisms Customisation |
| url | http://link.springer.com/article/10.1186/s12913-018-3352-y |
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