Barriers and facilitators to measuring patient reported outcomes in an academic breast cancer clinic: An application of the RE-AIM framework

Am J Surg. 2024 Feb:228:180-184. doi: 10.1016/j.amjsurg.2023.09.022. Epub 2023 Sep 15.


Background: Patient reported outcome measures (PROMs) are important for patient-centered, value-based care; however, implementation into surgical practice remains limited. We aimed to demonstrate feasibility of measuring PROMs in an academic breast cancer clinic.

Methods: We conducted a pilot study implementing the patient-reported outcome measure BREAST-Q among patients with Stage 0-III breast cancer at a single institution from 06/2019-03/2023 using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Barriers and facilitators were characterized. Survey completion was assessed pre-operatively and up to 12 months post-operatively.

Results: Barriers included limited time and lack of incorporation into the electronic medical record. Facilitators included utilizing trained team members and an automated workflow. Among eligible patients, 74% completed BREAST-Q at 2-weeks post-operatively and 55% at 12 months post-operatively.

Conclusions: We describe the implementation of a PROM using the RE-AIM framework, highlighting facilitators and barriers that may assist others in collecting patient-reported outcome data.

Keywords: BREAST-Q; Breast cancer; Implementation; Patient reported outcome measures; Patient reported outcomes; RE-AIM.

MeSH terms

  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Patient Reported Outcome Measures
  • Patients
  • Pilot Projects
  • Surveys and Questionnaires