Questioning the questionnaire: a Dutch national survey on generic patient-reported outcome measures in traumatology

Background
PROMs are fairly new in medical practice. In trauma surgical care in the Netherlands, it is unknown to what extend (generic) PROMs are embedded into clinical care. This study evaluates the awareness of generic PROMs in trauma and orthopedic surgeons in the Netherlands by assessing the current implementation, barriers and facilitators in usage of PROMs and willingness to assess other health domains besides the physical health domain.

Methods
A purposive sampling survey was conducted in all active associates of the Dutch Trauma Society. Furthermore all medical members of the regional trauma assembly in multiple network regions were invited to complete the survey.

Results
Generic questionnaires and information about physical health, mental health, social health and work status were acknowledged as useful In facilitating decisions and information about patients in trauma surgical care. Important assumed barriers of generic PROMs were the inability to intervene in health domains outside surgical treatment modalities (44%) and the negative influence on time management (43%). Yet, 55% of participants acknowledged generic information as the biggest advantage of generic PROMs, because of a wider therapeutic scope for specific health issues and better comparison of health outcomes between subgroups. Sustainable implementation of questionnaires required integration and fully automation of questionnaires in electronic patient files.

Conclusion
Barriers have to be overcome for successful and sustainable implementation of (generic) PROMs in trauma surgical care. Broad support from trauma care professionals and the development of intelligent technological solutions that can seamlessly support clinical workflows are crucial to successful implementation.