Strategies to improve clinical practice through guidelines experience from recent studies
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Strategies to improve clinical practice through guidelines experience from recent studies

Strategies to Improve Clinical Practice Through Guidelines: Experience from Recent Studies

Michael Cabana (UCSF)Rebecca Beyth (University of Florida)Kathy Berra (Stanford University) Thomas Bailey (Washington University) Benjamin Crabtree (Robert Wood Johnson Medical School)Catarina Kiefe (University of Alabama at Birmingham)

Funded by the National Heart, Lung and Blood Institute


Clinical practice guidelines cpgs
Clinical Practice Guidelines (CPGs) Experience from Recent Studies

  • Systematically developed statements to influence practitioner and patient decisions about appropriate health care for specific clinical circumstances.

  • Potential impact:

    • Change physician behavior to promote appropriate use of interventions

    • Improve the outcomes of medical care

    • Reduce variation in medical care

  • CPGs have limited effect despite efforts for several decades (e.g., JNC and ATP)


Initiative history
Initiative History Experience from Recent Studies

  • NHLBI released an RFA in 2001 to fund “Trials Assessing Innovative Strategies to Improve Clinical Practice through Guideline Implementation in Heart, Lung, and Blood Diseases.”

  • 8 projects funded in 2002

  • 3 additional projects funded in 2003

  • Investigators have met several times to share ideas, discuss barriers and lessons learned.

  • Initiative includes requirement for sharing approaches and disseminating tools and results.


Project themes
Project Themes Experience from Recent Studies


Bodenheimer T, et al. JAMA 2002; 288:1775-1779. Experience from Recent Studies

Bodenheimer T, et al. JAMA 2002; 288:1909-1914.


Agenda
Agenda Experience from Recent Studies

  • Clinician behavior change

  • Role of Informed, Empowered Patient and Family in Improving Clinical Practice through Guidelines

  • Integrating Information Technology into clinical practice: Tools for clinical decision support and guideline implementation

  • Organizational Change and Team Building

  • Conclusions and Implications


Agenda1
Agenda Experience from Recent Studies

  • Clinician behavior change

  • Role of Informed, Empowered Patient and Family in Improving Clinical Practice through Guidelines

  • Integrating Information Technology into clinical practice: Tools for clinical decision support and guideline implementation

  • Organizational Change and Team Building

  • Conclusions and Implications


Agenda2
Agenda Experience from Recent Studies

  • Clinician behavior change

  • Role of Informed, Empowered Patient and Family in Improving Clinical Practice through Guidelines

  • Integrating Information Technology into clinical practice: Tools for clinical decision support and guideline implementation

  • Organizational Change and Team Building

  • Conclusions and Implications


Agenda3
Agenda Experience from Recent Studies

  • Clinician behavior change

  • Role of Informed, Empowered Patient and Family in Improving Clinical Practice through Guidelines

  • Integrating Information Technology into clinical practice: Tools for clinical decision support and guideline implementation

  • Organizational Change and Team Building

  • Conclusions and Implications


Agenda4
Agenda Experience from Recent Studies

  • Clinician behavior change

  • Role of Informed, Empowered Patient and Family in Improving Clinical Practice through Guidelines

  • Integrating Information Technology into clinical practice: Tools for clinical decision support and guideline implementation

  • Organizational Change and Team Building

  • Conclusions and Implications


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