Barriers |
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Time investment, gathering endpoints, and patient needs: the length and total volume of the MDS for patients with NSLBP, gathering endpoint measures in the absence of patients, not meeting patient expectations |
External pressure: the need to meet external requirements regarding scores on process and outcome indicators, stimulating inappropriate ways of collecting data; noticeably formalized to just ‘fulfill’ these demands |
Financial aspects: narrow additional insurance, limited time available within these budgets is preferably spent treating the patient at the expense of collecting data |
Population characteristics: lack of digital skills and low (health) literacy of patients constrain legitimate data collection |
Irrelevant content, overlap between and scope of questionnaires: inappropriateness of questions and applicability for every treatment profile, existence of overlay in questions and measures of the MDS regarding physical activity and functioning |
EHR system specifications: lack of a well-functioning EHR system and specifications to guide online data collection, lack of external reminders for data collection |
Lack of knowledge and skills: how to interpret (clinical relevance) and how to apply data to support clinical behavior |
Facilitators |
Goal-setting; functional, specific, and concise instruments: relevant aspects for the patient, short and easy to apply questionnaires, dynamic questionnaires; computer-assisted testing (CAT) |
External reminder for data collection (future assurance): external reminder to complete data collection in open treatment episodes, through a quality manager or the EHR system |
Awareness of the added value of data collection to improve quality of care: more knowledge of the why and relevance of data collection may stimulate behavioral change, including communicating the value of data collection to patients |
Education on how to handle the collected data to support clinical behavior: more attention paid to data collection routines (including EHR aspects) and handling data in routine practice during the undergraduate education of physical therapists |
Overview of results: making the most relevant and eye-catching outcomes of completed questionnaires clearly visible (EHR system) |
Peer assessment atmosphere: open and safe environment and incentives to reflection through open-ended questioning |
Rapid improvement nature of the program: enhanced involvement and awareness regarding the transfer-of-learning |