The PRIUS method explicitly addresses the need for a brief and systematic method for collecting ongoing data about the status and progress of implementation from the perspectives of participants themselves. As a lead investigator on a project using this method, I can attest that it really gives the perspective of many different kinds of people over time about how the implementation process is unfolded. This technique addresses an outstanding need in healthcare research for an efficient, structured, and longitudinal method for capturing data on the status and progress of implementation.
To obtain a PRIUS score, at a mutually agreed upon time, meet the participant and pose the prompts asking for updates on the implementation of this project. Score each development with a seven-point scale ranging from plus three to minus three with zero as the middle value. Begin the session.
Well, great, we're here for our check-in, so I'm hoping to hear about some updates from the last time we spoke. So, if you just start with the first update. Well, so, the most exciting thing that's happened is that the database that we're using to identify eligible patients is finally up and running.
Okay, great. And would you say that's a positive, neutral, or a negative update? That's definitely a positive-Okay.event.
And in terms of its influence, would you say it's strong, medium, moderate, or weak? Strong.Okay.Strong, so it sounds like a plus three.Yes. And why would you say a plus three?
Well, I think it's really gonna help us to identify all of the potentially eligible patients and help us to recruit them in a really efficient way. Excellent, okay, great. Okay, do you have another update that you share?
I do. Unfortunately, many of the patients who we have scheduled for enrollment are too sick. They end up in the hospital and we're not able to enroll them in the program.
Okay, and again, would you say that's positive, neutral, or negative? That's a negative. That's a negative, okay.
And how strong of an influence, is it strong, moderate, or weak? I think it's a weak. Okay, a weak, so a negative one?
Yes.Negative one. And what would be the rationale for that? Well, I think it shows that we are enrolling the right patients.
We want to take care of the sickest patients. And I think that sometimes these things kind of come in waves, and so, it's just a recent new development and I'm hoping it won't last for too long. Okay, great.
Any other page you can think of? Well, we do have a new staff member who's just joined. Okay, and same thing, would you say that's positive, neutral, or negative?
I think that's neutral for today. Okay, neutral, great. And do you have any other further rationale for that?
Well, she's only just started and she's in training right now, so hopefully the next time we have an update, then it'll be a positive. But for right now, she's just in training. Okay, great, super.
Well, that's great, well, thank you for checking in with me. Thank you so much.Yeah. Later, use a spreadsheet template to capture each implementation related development that the participant reports under the column labeled, Update.
Each development gets its own row. For each development, enter the score that the participant reports in the spreadsheet for the column labeled, Score. Next, enter the rationale that the participant reports in the spreadsheet for each score.
A short text summary is sufficient. Then add any additional information to the optional comments column of the spreadsheet is appropriate including observed non-verbal cues such as facial expressions, body language, tone of voice, and or additional relevant details. Check in with each participant on a recurring basis.
Recording the participant provided information as demonstrated at each subsequent session. In this representative analysis, 12 staff members at a single Veterans Affairs Medical Center in the Midwestern United States participated in Prius sessions related to a quality improvement project over a six month period in 2016. This project resulted in a total of over 190 different Prius items.
The most frequent score applied by participants to Prius entries in this project was plus three. The highest possible score on the seven point minus three to plus three scale. Entry scored with a plus three included initial professional development and training events, interactions with the outside vendor, and implementation of new electronic tools.
The next most frequent score was minus two, the second lowest possible score. Entry scored with a minus two included interactions between individuals from different clinical areas. Slow initial patient enrollment and the need for follow-up training.
As intended, the Prius made the leader of the clinical intervention aware of an implementation issue that otherwise would've remained undetected, helped inform the development of a course correction and provided a way to evaluate the effect of that change on ongoing implementation. When asking participants to report and score implementation updates, it is extremely important to collect all three elements, the update, the score, and the rationale.
