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Overcoming Barriers to Using Patient‐Reported Outcomes for Clinical Inquiry

A patient-reported outcome (PRO) is a report or assessment of the status of a patient’s health or health care experience that comes directly from the patient.1 One common example used in acute and progressive care settings is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which assesses patients’ satisfaction with care in the hospital setting.2 Beyond providing a measure of satisfaction with previously delivered care, the broad array of available PROs represents a compendium of valuable tools for identifying patients’ future expectations for health-related goals, health engagement, or expectations for communication with health care providers, for example. Nationally, the Patient-Centered Outcome Research Institute has led the way in encouraging patients to engage actively with their health care team, in part through PRO surveys that ascertain, measure, score, or prioritize individual-level health beliefs, health goals, symptom perceptions, satisfaction with care and the care environment, and many other factors associated with the personal experience of health and illness.3 As nurses, we are increasingly focused on understanding and incorporating patients’ perspective in developing care plans and tailoring treatment regimens. To measure the effect of these efforts on the patient’s perceived quality of care, and to develop new knowledge for more effective patient-centered care planning, PROs are an important tool for clinical inquiry. The ability of PROs to serve a dual purpose, functioning both as a tool to guide care and as a measure of the quality of care delivered, enables these publicly reported scores to be particularly well suited for measuring change and evaluating improvements in quality. And yet, in clinical practice, a number of factors pose barriers to broad-scale use of PRO surveys as tools to guide care and evaluate outcomes in real time. Chief among these is the limitation of time itself. The purpose