Encouraging Patient Participation in Outcomes

Like a good conversation, outcomes collection is a two-way street, especially when it comes to patient-reported outcome measures (PROMs). But being a good clinician doesn’t necessarily make you a good communicator. Perhaps you aren’t sure how to convince your patients that outcomes are important—or that they need to take an active role in their own treatment to ensure their outcomes are optimal. Or maybe you just don’t know how to ensure patients properly complete their outcomes questionnaires. Either way, getting your patients into outcomes—and involved in their health care—means you’ll get better data out of your efforts. And we’ve got a few ideas to help:

Ensure Accuracy

Sure, PROMs require patient participation, but that doesn’t mean your patients know how to complete them accurately and honestly—or understand why they even need to complete them at all (more on that later). And if the responses you collect from those patients aren’t accurate, honest, or complete, the data will be practically worthless. Plus, your plan of care is only as successful as the information you base it on, so it’s important to get the right data from the start. With that in mind, you absolutely should educate your patients on these three points:

• How to complete each questionnaire,
• How you will use their responses, and
• How their participation benefits them directly.

Providing this type of education doesn’t have to be time-intensive. As Brooke Andrus writes in this blog post, all you need to do is include a simple paragraph explaining the purpose of each survey, like the one below:

Please complete this survey as thoroughly and honestly as possible. There are no right or wrong answers, and while some items may be more relevant to your case than others, we encourage you to answer all questions. Your responses will provide insight into how we’re doing and how we can better help you progress toward your goals. Your individual survey information will be shared with our care team only.

Some patients will still need additional assistance, so the American Joint Replacement Registry’s guide to PROMs advises practitioners to have patients “complete the first form electronically at the clinic so they can ask questions if they need help. Patients may be more prone to complete follow-up surveys once they are familiar with the survey process.” If possible, provide each patient with a device—iPads are great for this—that he or she can use to complete the forms quickly and easily.  

Encourage Involvement

Trust me: your patients want to improve. But, if you don’t require them to make it a team effort—that is, if you don’t push them to play an active role in their treatment—then they won’t see the full benefit of that treatment. In fact, they may not stick with it at all. Ultimately, that means they (and you) won’t achieve optimal outcomes.

Share Information

Your patients may know how to fill out the their outcomes surveys, but that doesn’t guarantee that they’ll actually do it. That’s why it’s crucial that you stress the importance of PROMs—and outcomes in general—through shared decision-making. Thankfully, most patients actually want to be involved. According to a 2008 policy brief from the World Health Organization (WHO), “One of the most common sources of patient dissatisfaction is not feeling properly informed about (and involved in) their treatment.” The good news? The WHO asserted that “as patients become more involved, their knowledge improves, their anxiety lessens and they feel more satisfied.” Furthermore, this Families USA publication confirms that “patients who are more involved in their health care are happier with their health care decisions and are more likely to follow treatment plans, which can lead to better health outcomes.”

Set Expectations

Tired of patients disappearing after four visits? Sick of patients telling you they didn’t follow their HEP? Here’s the thing: It’s not enough to share information about treatment decisions at the outset of care; you also have to set the expectation that your patients will be involved throughout their whole recovery process, too. Once you’ve taken the time to explain a patient’s treatment options, it’s time to help that patient understand what’s required of him or her and what outcome he or she should expect at the end of treatment (given the patient’s specific condition).

Take Action

So, now what? How should you go about sharing treatment options and setting expectations? Based on the above-cited WHO policy brief and this Families USA publication, here are four ways clinicians can help patients take part in their treatment:

1. Provide patients with clear and unbiased information about their conditions and treatment plans so they can make informed decisions. Pay special attention to helping patients understand how their lives might change based on their decisions. To do so, provide patients with prompt cards that give examples of questions the patients might want to ask about their treatment and care.
2. Offer advice and guidance—using evidence-based patient decision aids—tailored to each patient's’ specific needs and circumstances.
3. Discuss each patient’s options with him or her, making sure to come to a mutual decision.
4. Give your patients access to their medical records. Families USA indicates that the “most effective shared decision-making programs will have electronic health records (EHRs) that can track patients, increase communication between patients and providers, and give patients access to their records.”

Are you an expert at helping your patients become invested in their outcomes? Leave your time-tested tips in the comments section below!