6. Implementation of PRO assessment in clinical practice

Summary

Implementing PRO assessment in clinical practice is complex and requires attention to many factors. A structured, nine-step approach can guide the required tasks and work packages:
  1. Create a shared vision: convince key interest-holders of PRO assessment’s potential to start implementation
  2. Define goals and scope: agree on what PRO assessment should achieve and where it will be implemented
  3. Check-setting-specific conditions: analyse implementation- and use-relevant factors using appropriate methods
  4. Model the target workflow: define the PROMs, assessment mode, data use, and responsibilities
  5. Establish necessary preconditions: set up what is needed (agreements, procurement, adaptations, developments)
  6. Train clinical staff: prepare staff to use PRO assessment and PRO data through suitable training content and methods
  7. Integrate the intended procedure: pilot on a small scale, expand gradually, and monitor closely
  8. Evaluate to optimise and sustain: collect and analyse implementation and use of PRO data with appropriate outcomes and methods
  9. Scale up towards new goals: use evaluation results, experience, and created resources to support future implementations

Across all steps, engage (identify, inform, involve, motivate) relevant interest-holders, especially patients, decision-makers, HCPs, and administrators. A pragmatic mindset (realistic expectations, flexibility, long-term perspective, and clear communication) helps address implementation challenges.