161 Assessment of the KLIK PROM portal implementation Table 1. Description of the most prominent determinants of successful KLIK implementation using CFIR CFIR domain CFIR determinants Reasons for successful implementation Intervention characteristics Evidence Strength & Quality • Effectiveness studies showed that KLIK is acceptable, valuable, and feasible [7,12] • The evidence of KLIK is emphasized in the training for clinicians [34] Intervention characteristics Trialability • KLIK started small and has found its way, step by step, in many hospitals and has scaled up to adult healthcare and other countries • A license agreement is signed at the start, which can be ended and therefore undo the implementation if needed • The implementation process and workflow are adapted according to the wishes of every multidisciplinary team, as the KLIK team experienced that a ‘one size fits all’ approach was not feasible Intervention characteristics Design Quality and Packaging • Clear and direct available feedback of PROMs on a well-designed dashboard • The design of the KLIK PROM portal is evaluated positively, both by clinicians and patients [35] • A strength of KLIK is the design of the PROM feedback and the variety of options [36] • Optimization of the PROM feedback in KLIK is an ongoing process, based on scientific knowledge [37] and user experience Outer setting Cosmopolitanism • Worldwide, there is increased motivation for the use of PROMs in clinical practice, e.g., Value Based Healthcare supports the use of PROMs, which facilitates the implementation climate • The KLIK expert team shares common experiences with other hospitals through collaborations and networks (e.g., ISOQOL, PROMIS, research projects, implementation in many Dutch hospitals and the UK). Therefore, the KLIK PROM portal is increasingly well known and more visible for interested stakeholders Outer setting External Policy & incentives • Former research showed lack of formal agreements, such as policy and work plans on using KLIK at a hospital level [29]. However, this is changing, because from a governmental perspective, collecting PROMs or using Routine Outcome Monitoring for benchmarking purposes is increasingly encouraged or even obligated Inner setting Goals and feedback • During the KLIK training goals on implementing PROMs are clearly communicated, as previously different expectations were noticed (e.g., discussing PROMs in the consultation room versus collecting PROMs for research purposes), which may hinder the implementation • Clinicians receive feedback regarding the implementation process during the annual evaluation meetings 6
RkJQdWJsaXNoZXIy MTk4NDMw