Train Care Providers & Staff

Providers and staff are critical for successful implementation. Provide training on how to 1) access, 2) interpret, and 3) use scores from patient-reported outcome measures.

Provide Rationale

• Inform providers and staff of the rationale for collection of patient-reported outcome measures within a specific clinic (e.g., screening for problems, monitoring important symptoms). See Implement for Patient Care for examples of aims.
• Highlight how individuals’ tasks fit into the broader goal.
• Consider having the clinician champion present the rationale.

Demonstrate Workflow and Staff Responsibilities

• Demonstrate how a staff member will:
  • Identify if a patient needs to complete an assessment.
  • Facilitate completion of the assessment (e.g., distribute a tablet).
  • Disinfect, charge, and store (if applicable) any shared device (e.g., tablet computer).
• Review procedure for non-English speaking patients.
• Provide a script for staff and providers to use with patients explaining the value of patient-reported outcome data for patient care.
• Identify who is responsible for each task.

Train Providers on How to Access Scores

• The location of scores varies by Administration Platform. Create materials that show this location, how it is accessed, and when in the clinic workflow it is intended to be accessed.
• Include other enabled features (e.g., automatic generation of phrases/text, graphed scores) in training as well.
• It is helpful to have a demonstration test patient with several months of data.

Train Providers on How to Interpret Scores

Multiple resources exist to facilitate interpretation of patient-reported outcome scores. Utilize these resources to create training materials for clinicians. There are many aspects of interpretation including:

• Score metric (e.g., T-scores, percentiles, 0-10 scales. See PROMIS Scores for example).
• Directionality (e.g., higher scores = better health. See PROMIS Scores for example).
• Descriptors associated with score ranges (e.g., within normal limits, mild, moderate, severe. See PROMIS Score Cut Points for example).
• Meaning of score change over time (e.g., Is this amount of change meaningful to the patient? Is this amount of change expected? See PROMIS Meaningful Change for example.)
• The clinician champion should provide example cases of how information from patient-reported outcome measures can be used.  The Use Results in Clinical Care page provides more information. Learn more>>

Who and How to Train

• Identify which staff members (e.g., front desk staff, staff that room patients, float pool) are expected to interact with patient-reported outcome measure implementation and will need training.
• All care providers (e.g., doctors, advanced practice providers, nurses, social workers, health psychologists) expected to use patient-reported outcome measures for patient care should be trained to maximize use and benefits.
• Tailor training to audience (staff or provider).
• Identify where and how providers and staff are currently trained on new technology features (e.g., presentation at standing meeting, special training session, distribution of printed instructions, train-the-trainer models) and utilize that approach.
• Hands-on training is recommended.
• Provide printed instructions for reference.
• Express appreciation for hard work and assumption of new responsibilities.
• Provide a brief refresher/optimization session after a period of use following implementation.
  • Share evaluation metrics.  Learn more>>

Examples of Training Resources

The Agency for Clinical Innovation in New South Wales, Australia, offers a 4-part online education modules for clinicians, service managers, frontline administration, and patients. Access requires creating a free account and logging in. Learn more>>

• Module 1: The Importance of Patient-Reported Measures
• Module 2: Making [Implementation] Happen
• Module 3: Clinical Application (including effective approaches to using PROs in clinical interactions)
• Module 4: Using Patient-Reported Measures to Create Positive Change (focus on quality improvement)

Short (2 - 6 minute) videos are also available including how clinicians integrate information from the patient-reported measure in the clinical interaction, patient perspectives, and addressing implementation challenges. Watch here>>

Additional References

Santana, M.J., Haverman, L., Absolom, K. et al. (2015). Training clinicians in how to use patient-reported outcome measures in routine clinical practice. Qual Life Res 24, 1707–1718. https://doi.org/10.1007/s11136-014-0903-5