Implementation Frameworks

Implementation Science frameworks can guide efforts for integration and evaluation of patient-reported outcome measures in clinical care.

Frameworks Used for Patient-Reported Outcome Implementation for Patient Care

Stover and colleagues (2021) compared four case studies of implementation of patient-reported outcome or experience measures in routine clinical care settings. Barriers were consistent across sites whereas enablers were context-specific. Implementation strategies and evaluation were also compared. The four studies include:

• Ahmed and colleagues (2021) utilized the Theoretical Domains Framework (TDF) Consolidated Framework for Implementation (CFIR) to implement patient-reported outcome measures for clinical care and quality improvement in pain clinics.
• Manalili and colleagues (2021) utilized the Knowledge to Action Cycle and Consolidated Framework for Implementation Research (CFIR) to implement patient-reported experience measures for quality improvement in primary care.
• Roberts and colleagues (2021) utilized the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) as a framework for implementation in oncology clinics.
• Van Oers and colleagues (2021) utilized the Consolidated Framework for Implementation (CFIR) retrospectively evaluate implementation of patient-reported outcome measures in pediatric and adult clinics.

Custom Selection and Implementation Framework

In the Netherlands, van der Wees and colleagues (2019) developed a framework and tools using user-centered design specifically for the selection and implementation of patient-reported outcome measures in clinical settings. It includes 4 phases:

1. Goal setting
2. Selecting patient-reported outcomes and measures
3. Developing and testing of quality indicators
4. Implementing and evaluating the patient-reported outcome measures and indicators