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Providing Expert Collaboration for the Development and Implementation of Evidence-Based Practices

Providing Expert Collaboration for the Development and Implementation of Evidence-Based Practices. Rachel R. Walden, Jack Starmer, Robert Dittus , Zachary E. Fox, Melissa McPheeters, Tracy C. Shields, Nunzia B. Giuse Vanderbilt University Medical Center May 2013.

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Providing Expert Collaboration for the Development and Implementation of Evidence-Based Practices

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  1. Providing Expert Collaboration for the Development and Implementation of Evidence-Based Practices Rachel R. Walden, Jack Starmer, Robert Dittus, Zachary E. Fox, Melissa McPheeters, Tracy C. Shields, Nunzia B. Giuse Vanderbilt University Medical Center May 2013

  2. Collaborative effort to inform and standardize institution-wide evidence-based practice Clinical Practice Committee Clinical Experts Provide context Enterprise Group Medical Center leaders who provide priorities & approval Information Experts Research and evaluation of existing evidence Institutional Experts Provide data on cost, use, and opportunities Implementation Integrates informatics, policy, and education approaches Project Leaders Coordinate and communicate efforts, gain buy-in Methods Experts Inform research & statistical methods

  3. Understand the topic, context, and timeline • Search high-quality evidence-based guidelines and evidence reviews from USPSTF, NICE, AHRQ • Search guidelines & evidence of unknown or lesser rigor from relevant organizations, PubMed, and Guidelines.gov • Use primary literature for updates, clarification, specific questions • Adapt process for different concerns and priorities Research Process Quality Review & Detailed Documentation

  4. Background research on rates of overuse • Tier 1 resources: high-quality evidence-based guidelines and evidence reviews from USPSTF, NICE • Tier 2 resources: guidelines & evidence from ACR, ACS, ASA, and other organizations, PubMed and Guidelines.gov search results • Evaluation using AMSTAR, AGREE methods • Primary literature: clarifying utility for lung cancer detection Routine preoperative chest X-ray Quality Review & Detailed Documentation

  5. Search: Systematic Reviews & Guidelines

  6. Organizational Guidelines

  7. Documentation of all CW recommendations & associated references • Evaluation of all references for type and quality of evidence, agreement with CW recommendation, • Follow-up: more in depth review of specific topics may occur http://www.choosingwisely.org/ Quality Review & Detailed Documentation Choosing Wisely

  8. Full document includes keywords, PICO, links, & additional commentary

  9. Define approaches that account for time limitations • Write methods documents for searching and synthesis • Document, document, document • Agree on “evidence” and advocate for quality • Be clear about disclaimers, limitations • Recognize that some topics have more impact, generate more enthusiasm than others • Prepare in advance to take advantage of opportunities Lessons Learned

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