Implementation of My Hearing PREM into three UK audiology services: a pluralist approach to planning, design and evaluation

Abstract

Introduction: My Hearing PREM (patient reported experience measure) is a validated tool for use in audiology services, to measure patients' experiences of living with hearing loss, and support from family and services. This study planned and evaluated the process of implementing My Hearing PREM into audiology services. Methods: Implementation planning and design was informed by the person-based approach and involved patients, public and audiology staff. My Hearing PREM was implemented into three NHS audiology services for 3 months. Evaluation of implementation used quantitative methods to determine PREM use and cost, and qualitative interviews with staff and patients to assess the implementation process. Results: A total of 95 participants contributed data across planning to evaluation. Clinicians were generally willing to use the PREM and it was seen as a tool to access the lived experience of patients. Patients felt the PREM enabled them to reflect on their situation and experiences. The per patient cost of PREM implementation was between £1.57 and £3.18. PREM use varied across sites and integration into routine practice was inconsistent. Barriers to use within services included time constraints, difficulties in storing responses on electronic systems, discomfort from staff asking patients about their perceptions of clinical care, and views that it duplicated work. Conclusions: My Hearing PREM can support, at low cost, more personalized, reflective care in audiology by bringing patient experience to the fore. Long-term integration in clinical services will depend on tackling practical barriers as well as addressing clinician concerns about the purpose of PREMs and aligning with services' ways of working. Patient or Public Contribution: A PPIE representative with lived experience of hearing loss contributed throughout. They contributed to the development of interview schedules, reviewed data analysis interpretations to ensure findings reflected participants experiences, and provided guidance on the development of implementation resources. This collaborative approach ensured that the implementation planning remained grounded in the real-world experiences and need of people with hearing loss.