6. Implementation of PRO assessment in clinical practice
7. Integrate the intended procedure
Once sufficient staff have been trained, begin routine implementation by integrating PRO assessment across three phases.
Purpose: Testing of the intended PRO procedure on a small scale to resolve early “teething” issues before wider use.
ePRO test run: Have IT run the procedure with virtual patients before testing on real patients.
Pragmatic sample: Start with a small group of patients who can and are willing to complete the PROM and few motivated HCPs.
Monitoring: Closely observe implementation to identify and fix workflow, training, and usability problems.
Use lessons from the pilot to refine the process and guide wider rollout.
Prerequisite: Piloting successful and necessary adjustments implemented to ensure a smooth workflow.
Scope: According to defined goals and intended coverage.
Pace: Adjust to local conditions and available resources.
Recommended approach: Gradual scale‑up e.g., one patient group → several groups → all patients; one assessment time → multiple times → all assessment times.
Principle: Prioritise sustainability over speed, advance only when the current step is consistently manageable.
... to promptly identify any issues or needs for adjustment arising in real-life clinical practice.
Monitoring methods can include
observation of clinical practice to examine how the PRO assessment and data are being used
analysis of the clinical documentation and/or PROM software to understand the frequency of PROM completion and the use of the data
Meetings with team members (e.g. the whole team, individual members, and/or those responsible) to review the current status of implementation and jointly identify solutions to challenges.
Based on the monitoring, further adjustments may be made to optimise the workflow and its integration.
Antunes, Harding, Higginson, & EUROIMPACT, 2014; E. Basch et al., 2012; Ethan Basch, Rogak, & Dueck, 2016; Nordhausen et al., 2022; Skivington et al., 2021; Snyder et al., 2012; Wintner et al., 2016; ISOQOL, 2015
