Patient reported outcome measures: environmental scan of the Australian health care sector and international literature review
Australian Commission on Safety and Quality in Health Care
Duration: May – October 2016
Download the final reports
The CHSD was commissioned to undertake a project to inform the work of the Australian Commission on Safety and Quality in Health Care. The objective of the project was to produce an environmental scan and literature review on the subject of patient-reported outcomes (PROs) and their measurement with a particular focus on the potential purpose and benefits of national-level collation or collection. It was an ‘early stage’ piece of work that may contribute to the development of a framework to support national collation of patient-reported outcome measures (PROMs).
PROs encompass a wide range of measurable outcomes of care from the patient’s perspective, including symptoms, quality of life and functional status. They can be defined as follows: “A PRO is directly reported by the patient without interpretation of the patient’s response by a clinician or anyone else and pertains to the patient’s health, quality of life, or functional status associated with health care or treatment” (Weldring and Smith 2013). PROMs are the tools or instruments used to measure PROs.
What we did
The environmental scan captured the current status of PROMs in the Australian public and private health sector. The analysis mapped what could be found through web-based searching about the current use of PROMs in Australia at the national, jurisdictional and organisational level; explored how PRO information is used at an aggregated level to improve quality and safety in health care in Australia; identified obvious gaps in the collection and use of PROMs nationally; and highlighted existing and emerging trends in the collation and use of PROMs in Australia to improve safety and quality.
The literature review has addressed the research questions, presenting the literature on the rationale for PROMs, mechanisms for collecting PROMs, reported uses of PROMs for quality improvement and other purposes, and the evidence on impacts of PROMs on quality and safety outcomes and implementation challenges. The evidence was found to be strongest for their use in understanding variation in clinical practice, as they can help in determining the relative effectiveness of different treatments and interventions. Good evidence was also identified that the use of PROMs enhances processes within the patient-clinician interaction. The review also described the primary reasons cited in the literature for the adoption of PROMs, and the main mechanisms used internationally for the routine collection and aggregation of PRO information.
Implications for a national approach to PROMs in Australia were discussed, and recommendations for future steps were provided to the Australian Commission on Safety and Quality in Health Care to facilitate improvements in healthcare quality and safety.
Further PROMs work
A third component of this program of research was undertaken - a series of interviews with representatives from all Australian jurisdictions and with Australian and international experts. Together, these three pieces of work provide a foundation for the specification of options for the extent and nature of the Commission’s future national leadership role in the area of PROMs.
Project team: Cristina Thompson, Jan Sansoni, Kate Williams, Darcy Morris, Jacqueline Capell and Pam Grootemaat