Implementation Challenges Using a Novel Method for Collecting Patient-Reported Outcomes After Injury

Graeme M. Rosenberg*, Emily J. Shearer, Sean R. Zion, Sean C. Mackey, Arden M. Morris, David A. Spain, Thomas G. Weiser

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Monitoring longitudinal patient-reported outcomes after injury is important for comprehensive trauma care. Current methodologies are resource-intensive and struggle to engage patients.

Materials and methods: Patients >= 18 y old admitted to the trauma service were prospectively enrolled. The following inclusion criteria were used: emergency operation, ICU length of stay >= 2 midnights, or hospital length of stay >= 4 d. Validated and customized questionnaires were administered using a novel internet-based survey platform. Three-month follow-up surveys were administered. Contextual field notes regarding barriers to enrollment/completion of surveys and challenges faced by participants were recorded.

Results: Forty-seven patients were eligible; 26 of 47 (55%) enrolled and 19 of 26 (73%) completed initial surveys. The final sample included 14 (74%) men and 5 (26%) women. Primary barriers to enrollment included technological constraints and declined participation. Contextual field notes revealed three major issues: competing hospital tasks, problems with technology, and poor engagement. The average survey completion time was 43 +/- 27 min-21% found this too long. Seventy-four percent reported the system "easy to use" and 95% reported they would "very likely" or "definitely" respond to future surveys. However, 10 of 26 (38%) patients completed 3-mo follow-up.

Conclusions: Despite a well-rated internet-based survey platform, study participation remained challenging. Lack of email access and technological issues decreased enrollment and the busy hospitalization posed barriers to completion. Despite a thoughtful operational design and implementation plan, the trauma population presented a challenging group to engage. Next steps will focus on optimizing engagement, broadening access to survey reminders, and enhancing integration into clinical workflows. (C) 2019 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)277-284
Number of pages8
JournalThe Journal of surgical research
Publication statusPublished - 28 Apr 2019

Keywords / Materials (for Non-textual outputs)

  • Patient-reported outcomes
  • Traumatic injury
  • Patient-reported outcome measures
  • Implementation science
  • CARE
  • PAIN


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