Change Project Dissertation: Introduction of Patient Reported Outcomes Measures on a Multi Disciplinary Team Outpatient Clinic

This organisational development project involved the introduction of Patient Reported Outcome Measures (PROM) to a Multi-Disciplinary Team (MDT). It provides interdisciplinary assessment; diagnosis, treatment planning and follow-up care for patients undergoing orthognathic treatment.

Current literature highlights the worldwide drive for quality improvements in healthcare, especially in the use of patient experience as a metric. Simultaneously healthcare budgets are under severe pressures. This has resulted in orthognathic service being targeted by some commissioning groups in the UK as a ‘low treatment need’ service due to the lack of high quality evidence of its benefits. This has lead to the development of a National Orthognathic Outcome Database including the use of PROM tools to assess the impact of this treatment on patients’ quality of life. This encompasses patient experience, which is a key metric of quality. Therefore, this change project is in line with government policy on quality improvement and evidence based medicine.

The HSE Change model was used to plan the introduction of and ensure compliance with the new national database. This included the introduction of PROM tools to the MDT to determine treatment effect as evidenced by changes in patients’ quality of life. The project was evaluated using the CIPP model, which indicated the aims and objectives were achieved. Results from the first three months of PROMs introduction indicated a high completion rate for the questionnaires and compliance with database completion. There was a statistically significant difference between pre and post treatment quality of life scores for orthognathic patients (P<0.05).

The PROMs data collected is extremely valuable both to inform commissioning groups of treatment benefits and justify service funding, while also providing patient experience data as a quality improvement metric.