癌症患者会经历影响生活质量的症状。尽管已有措施和临床指南存在，但及时的症状管理在肿瘤学护理中仍存在不平衡。我们描述了一项研究，旨在在成人门诊癌症护理中实施和评估电子健康记录（EHR）集成的症状监测和管理计划。我们的癌症患者报告的结局（cPRO）症状监测和管理计划是一个定制的EHR集成安装程序。我们将在Northwestern Memorial HealthCare（NMHC）血液/肿瘤诊所中实施cPRO。我们将进行集群随机修改的阶梯式试验，评估患者和临床医生对cPRO的参与情况。此外，我们将嵌入一个患者级随机临床试验，评估额外增强护理（EC；cPRO加网上症状自我管理干预）相对于常规护理（UC；cPRO单独）的影响。该项目采用了第2型混合效果-实施方法。干预措施将在由32个诊所站组成的医疗保健系统内的7个区域群集中实施。将进行为期6个月的前瞻性预实施招募期，随后是后实施招募期，在此期间，新入选的同意患者将随机分配（1：1）到EC或UC。我们将在入院后的12个月内跟进患者。EC随机分配的患者将使用基于网络的工具（“MyNM Care Corner”）获得有关与癌症相关问题和增强生活质量方法的基于证据的症状管理内容。此设计允许在和之间对实施进行评估，并进行基于群体的比较以展示患者级结果的有效性。该项目有潜力指导未来医疗保健系统级别的癌症症状管理计划的实施。gov # NCT03988543。版权所有©2023 Elsevier Inc。

People with cancer experience symptoms that adversely affect quality of life. Despite existing interventions and clinical guidelines, timely symptom management remains uneven in oncology care. We describe a study to implement and evaluate an electronic health record (EHR)-integrated symptom monitoring and management program in adult outpatient cancer care.Our cancer patient-reported outcomes (cPRO) symptom monitoring and management program is a customized EHR-integrated installation. We will implement cPRO across all Northwestern Memorial HealthCare (NMHC) hematology/oncology clinics. We will conduct a cluster randomized modified stepped-wedge trial to evaluate patient and clinician engagement with cPRO. Further, we will embed a patient-level randomized clinical trial to evaluate the impact of an additional enhanced care (EC; cPRO plus web-based symptom self-management intervention) relative to usual care (UC; cPRO alone). The project uses a Type 2 hybrid effectiveness-implementation approach. The intervention will be implemented across seven regional clusters within the healthcare system comprising 32 clinic sites. A 6-month prospective pre-implementation enrollment period will be followed by a post-implementation enrollment period, during which newly enrolled, consenting patients will be randomly assigned (1:1) to EC or UC. We will follow patients for 12 months post-enrollment. Patients randomized to EC will receive evidence-based symptom-management content on cancer-related concerns and approaches to enhance quality of life, using a web-based tool ("MyNM Care Corner"). This design allows for within- and between-site evaluation of implementation plus a group-based comparison to demonstrate effectiveness on patient-level outcomes.The project has potential to guide implementation of future healthcare system-level cancer symptom management programs.gov # NCT03988543.Copyright © 2023. Published by Elsevier Inc.