174 Chapter 9 more data on how patients experience their ear problem(s) can be collected, the OQUA will become more precise, gain interpretability and it can be used for further improvement of quality of care and better shared decision making for patients with ear complaint(s). In chapter 7 a prospective and qualitative analysis using focus groups and interviews with ENT professionals (n=15) and patients (n=25) with ear complaints of one tertiary referral hospital and two regional hospitals was performed. The study identified several enablers, demonstrating that both groups are motivated to incorporate the OQUA into their daily practices. Patients appreciated the opportunity to reflect on their complaints and quality of life, while clinicians recognized the value of detailed insights and treatment feedback provided by the OQUA. The analysis also revealed that barriers to the use of the OQUA are associated with the capability, opportunity, and motivation of both ENT professionals and patients. Challenges persist at multiple levels: patient-level barriers (e.g., language and digital literacy), provider-level barriers (e.g., awareness and workload), and organizational barriers (e.g., workflow integration). We propose an implementation strategy focused on education and training regarding the purpose, outcomes, and relevance of the OQUA. Additionally, the strategy includes modifications to the digital environment to facilitate the optimal use of the OQUA. Finally, it emphasizes engagement and feedback mechanisms to ensure that the valuable insights provided by the OQUA are effectively utilized by patients, healthcare professionals, and the healthcare system.
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