A while ago, I alluded to the fact that the iMSK team @GSTTnhs were undergoing a project evaluating which outcome measures we should use to measure quality of our services.
This thread (long!) will try to summarise the results. Thanks to project leads @GuardPhysio @cbondage.

Historically we have used EQ5D5L (paper), which was an inefficient, time consuming process, and a poor measure of service quality. This project was commenced in Spring 2020 to evaluate patient and clinician preferences for measures.

In June 2020 (via Survey Monkey) we canvased….
1) Patients (n=86)- sent via automated texts
2) GSTT MSK Physios (n=26) sent via internal e-mails
3)External physios (n=16 )- sent via social media

RESULTS SUMMARY!
1) Patients are willing to complete digital PROMS
2) They are willing to complete multiple PROMS and spend over 3x longer than the time clinicians think they will.
3) Patients find it an easier process than clinicians think they do!

4) Clinicians seem to prefer generic or QoL measures (specifically MSK-HQ) as a preferred PROM
5) Both patients and staff deem service evaluation as extremely important and of high value.

Patient survey:
• 88% of patients willing to complete two separate PROMs if asked
• 3.5% find it difficult to complete PROMS (75% find it easy or very easy)
• Patients are 70% likely to be compliant with completing pre and post treatment PROMs

Patient survey ctd:
• Mean max time pts were willing to spend=19mins
• Mean maximum number of q's: 19
• No dominant preferred style or type of q's
• 97% felt important or extremely important to collect their opinions on service quality
•62% wanted feedback on performance

GSTT staff survey:
• 100% felt reporting of PROMs to measure clinical efficacy was important
• 0% report they always complete PROMS pre & post treatment
• Staff had low confidence that pt's would complete >1 measure (29% not likely, 41% slightly likely, 25% mod likely)

Staff survey:
• 41.6% felt a combo of questionnaires (patient specific, pathology specific and/or generic health indicator) would be the best method.
• 29% pref a patient specific valued outcome (e.g. PSFS)
• 4% pref a generic health indicator (e.g. SF-36)

Staff:
• Staff had mixed opinions on how easy completing PROMs are (difficult 37.5%, neither easy nor difficult (37.5%, easy 25%).
• Staff felt a mixed formatting type of questions within PROMS was preferable
• 60% felt feedback of PROMS results to patients was important.

External survey:
• Wide variation in measures
- 43.75% used Generic or QoL measures (e.g. MSK-HQ or EQ5D)
- 25% used patient specific PROMS (e.g. PSFS)
- 6.25% used pathology specific (e.g. LEFS)
- 25% used a combo!

External survey:
• 50% collected on paper, 25% via digital means, 25% used both
• Main risk to completion = time!
• External staff feel the maximum time patients should spend completing PROMs is 6-minutes (mean answer) (3x less than patients are willing to).

External survey:
• MSK-HQ, PSFS, or EQ5D were the preferred measures
• >70% were in favour of MSK-HQ. The consensus is that all 3 are supported by the literature, but MSK-HQ is ‘well validated, more specific and easy to use’.
• Individual responders ranged from B6-B8C

From here the team are evaluating the results of these surveys against a review of the literature in order to make decisions regarding which measures should be taken forward, and built into the development of an automated collection/ reporting system.

Key elements in the development of this system are:
- The ability to evaluate departmental quality over time through visual representation of patient outcomes longitudinally.
- Automated measure dissemination, collection, analysis and reporting.
- Modifiable over time

Pose all questions to @GuardPhysio @cbondage who have done fantastic work to present to the leadership team to make the best decisions for the service.

> THREAD END.