A generic and adaptable model of developing, implementing, and maintaining patient-reported outcomes in clinical...

Patient-reported outcomes (PROs) are aspects of health status reported directly by patients. Over the last decade, PROs have been increasingly used in clinical practice. AmbuFlex - Centre for Patient Reported Outcomes is a public-funded organization that develops, implements, and maintains PRO solutions in the Danish healthcare system. Since 2011, a total of 90 specific AmbuFlex PRO solutions have been implemented across diverse patient groups and hospital departments. AmbuFlex' implementation model is based on extensive real-life experience and inspired by theoretical frameworks, such as the Consolidated Framework for Implementation Research, the Medical Research Council's framework of development and evaluation of complex interventions, and the PROTEUS Guide to Implementing PROs in Clinical Practice. In this paper, we describe the AmbuFlex model for developing, implementing, and maintaining PRO solutions in clinical practice.

The process outlined in the AmbuFlex model comprises five steps: (1) Clarify PRO rationale, (2) Select PROMs, (3) Design PRO solution, (4) Implement and adjust PRO solution, and (5) Monitor, evaluate and expand PRO solution. Throughout the process, the active involvement of relevant stakeholders is essential. A PRO facilitator manages this iterative process, and a series of meetings are held with a clinical working group based on specific contextualized requirements.

The AmbuFlex model is a generic and adaptable model, that applies to the development, implementation, and maintenance of PRO solutions regardless of purpose, target group, clinical context, and stakeholders involved. Thus, the model is useful for developing and implementing sustainable PRO solutions in the healthcare system.