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Patient-reported Outcomes in Practice

Clinicians’ Perspectives From an Inpatient Psychiatric Setting

BURR, SEAN K., MA; FOWLER, JAMES C., PhD; ALLEN, JON G., PhD; WILTGEN, ANIKA, MEd; MADAN, ALOK, PhD, MPH

Journal of Psychiatric Practice®: September 2017 - Volume 23 - Issue 5 - p 312–319
doi: 10.1097/PRA.0000000000000250
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The use of patient-reported outcomes (PROs) has become increasingly common. They have been used to assess quality of care and to support policy decisions, but the evidence concerning their utility to improve patient outcomes is inconsistent. A better understanding of clinicians’ experience with PROs has the potential to improve their effectiveness. This exploratory, quantitative, and qualitative study investigated the perspectives of clinicians (N=70) from multiple disciplines (psychiatrists, psychologists, social workers, and psychiatric nurses) on the utility of PROs in an inpatient psychiatric setting. During scheduled, monthly, discipline-specific administrative meetings, clinicians in attendance completed a 1-time, 5-item survey. The highest rated item related to the frequency of reviewing outcomes reports; this item was rated higher than all other items (mean±SD, 4.5±1.5), which 37.5% of the participants in the overall sample stated they “always” did. The lowest rated item related to the frequency of conveying the results of the outcomes reports to patients (3.3±1.9), which 20% of participants reported “always” doing; this item was rated lower than all other items (P<0.03). Qualitative analyses were based on 30 comments from 22 clinicians, which resulted in the emergence of 6 themes. The 2 themes that received the highest number of comments related to: (1) the sensitivity and specificity of measures across the PROs platform and (2) the value of the reports in directly influencing treatment decisions. Clinicians’ relatively favorable perspective of PROs in practice in this study may be related to the assessment-oriented culture at the study institution. Nonetheless, many barriers to the routine use of PROs exist. Addressing clinician concerns has the potential to improve utilization of this facet of good clinical care.

BURR: The Menninger Clinic, Houston, TX, and City of Edmonton, Alberta, Canada

FOWLER, ALLEN, and MADAN: The Menninger Clinic and Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX

WILTGEN: The Menninger Clinic, Houston, TX

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, www.psychiatricpractice.com.

Partially supported by the Menninger Clinic Foundation and McNair Medical Institute. The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or manuscript.

A.M. is a McNair Scholar. The remaining authors declare no conflicts of interest.

Please send correspondence to: Alok Madan, PhD, MPH, 12301 South Main Street, Houston, TX 77035 (e-mail: amadan@menninger.edu).

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.