PPP-ARM: A QUALITY IMPROVEMENT BY INCORPORATING PATIENT INVOLVEMENT AND BY ADDING A DECISION AID FOR TERMINAL DEVICES

Authors

  • Paula A. Wijdenes
  • Nienke Kerver
  • Sacha van Twillert
  • Laura Boerema
  • Michael A.H. Brouwers
  • Corry K. van der Sluis

Abstract

Introduction: The Prosthesis Prescription Protocol of the upper limb (PPP-Arm), is a digital tool to structure, underpin and evaluate the prescription of upper limb prostheses (ULPs) in rehabilitation centres in the Netherlands that prescribe ULPs. The results of evaluating five years of PPP-Arm use, the recently developed Dutch Quality Standard for Prosthetic Care (D-QSPC) and the wish for facilitating shared decision-making led to this study. We aimed to develop and implement quality improvements and a patient decision aid (PDA) to the national digital protocol PPP-Arm. Methods: Improvements for PPP-Arm were identified by an evaluation with clinicians after five years of PPP-Arm-usage and based on the recommendations described in the D-QSPC, focussing on new elements that should be incorporated in PPP-Arm. The PDA about Terminal devices for people with Upper Limb Absence (PDA-TULA) was developed in a systematic co-creation process following the steps described by the International Patient Decision Aid Standards. The improved PPP-Arm and the newly developed PDA-TULA were pilot-tested in the real-life national rehabilitation setting. Results: The following improvements were made to PPP-Arm: the option to add images to the prosthesis application for the health care insurer, access for patients to PPP-Arm in order to complete surveys, digitally signing prosthesis applications, view educational material, and more structure was integrated in the description of the stepped care process. Furthermore, the PDA-TULA was added to PPP-Arm, which informs patients about available Terminal Devices (TDs), then stimulates the patient to consider their own preferences regarding the TD options, and lastly provides an overview of the patients' preferences in relation to the available TD options. Implementation of the pilot-test regarding the improvements of PPP-Arm is ongoing, we expect it will lead to better usability, modernization, and increased patient involvement in the treatment process. Pilot-testing of the PDA-TULA showed that patients and clinicians experienced benefits from the PDA-TULA regarding the prosthesis selection process. Conclusion: PPP-Arm has been improved, adjusted to the renewed D-QSPC, and supplemented with the PDA-TULA. Results emphasize the importance to cooperate with all stakeholders and pilot-test changes and new products in the real-life setting to develop and improve products that suits the needs of all stakeholders.

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Published

2022-08-09

How to Cite

[1]
P. A. Wijdenes, N. Kerver, S. van Twillert, L. Boerema, M. A. Brouwers, and C. K. van der Sluis, “PPP-ARM: A QUALITY IMPROVEMENT BY INCORPORATING PATIENT INVOLVEMENT AND BY ADDING A DECISION AID FOR TERMINAL DEVICES”, MEC Symposium, Aug. 2022.

Issue

Section

Clinical Practice