1 / 18

Canadian Knowledge Mobilization Forum 2012 - June 20, 2012

TEAM-beta: Treatment and Evidence Algorithmic Mapping – a platform for an efficient decision support tool for clinicians, researchers and funders. Dalton Wolfe 1 , Jane Hsieh 2 , Jennifer Hunter 2 , Amanda Khan 1 , Saagar Walia 1 & the Spinal Cord Injury Knowledge Mobilization Network

teva
Download Presentation

Canadian Knowledge Mobilization Forum 2012 - June 20, 2012

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. TEAM-beta: Treatment and Evidence Algorithmic Mapping – a platform for an efficient decision support tool for clinicians, researchers and funders Dalton Wolfe1, Jane Hsieh2, Jennifer Hunter2, Amanda Khan1, Saagar Walia1 & the Spinal Cord Injury Knowledge Mobilization Network 1: Parkwood Hospital, Lawson Health Research Institute 2: Ontario Neurotrauma Foundation Canadian Knowledge Mobilization Forum 2012 - June 20, 2012

  2. Outline • Objective: to describe the rationale and early concept development behind TEAMbeta (clinical decision making support tool) • Problem Identification: Too Much Information, Not Enough Knowledge (Is Practice Evidence-Informed?) • Solution: TEAMbeta, a map to information that is clinically relevant  Knowledge  Action • Initial Features and Methods

  3. A Vast Sea of Information: But is it Being Used in Practice (i.e. Behaviour Change)? • Challenges for Knowledge Users • Ever increasing volume and complexity • Access hindered by multiple barriers (competing demands, cost, feasibility) • Application hampered by inertia and inability to apply appropriately • What to do??? (Information  Knowledge  Action

  4. Spinal Cord Injury Rehabilitation Evidence (SCIRE): Knowledge Product Canadian collaboration between scientists and clinicians www.scireproject.com Expert synthesis  evidence statements

  5. SCIRE: Knowledge Product Platform Standards of Care Standards of Care (Informing SCI KMN, etc.) Outcome Measure Standardization (Outcome Measure Toolkit) Clinical Practice Development (e.g., Canadian Physical Activity / Pressure Ulcer Guidelines Knowledge Translation Case Studies (Modeling Evidence  Practice) TEAMbeta Outcome Measurement “How-to” Videos SCI-U (eLearning modules directed to the person with SCI = self-management) Research / Care Priorities Consensus Priority Setting Activities (base on Gap Analysis, strengths, etc.)

  6. SCIRE: Influencing Decision-Making Typical approaches to consensus-seeking activities do not place decision making in the context of practice Ultimate goal … To influence practice so as to improve outcomes

  7. Our Challenge How do we get information to users in a way they will use it? Goal: to enhance decision making and influence practice (action) by … Clinicians Researchers Funders / Policy makers / Administrators

  8. Our Solution: TEAMbeta • An algorithm to guide decision making that is consistent with the clinical situation (for pain management in persons with SCI) • Assessment • Diagnosis • Treatment • Each node represents links to further information

  9. Applying the Solution to the Real World • Identifying implementation targets for the Spinal Cord Injury Knowledge Mobilization Network (SCI KMN) • The SCI KMN is 6 Canadian rehab centres applying the principles of Implementation Science for best practice adoption Parkwood Hospital - London, ON Glenrose Hospital – Edmonton, AB Foothills Hospital – Calgary, AB IRDPQ – Québec City, QC IRGLM– Montreal, QC Toronto Rehab - Toronto, ON

  10. Delphi: Selecting Practices as Targets for Implementation • Successive rounds of considering practice options and voting • Participants voted according to set criteria DRAFT Canadian Practice Guidelines on Pressure Ulcers 48 Practices 1. ASSESSMENT: Conduct a comprehensive, systematic assessment of risk factors 2. EDUCATION: Provide structured pressure ulcer prevention education Best Practices 1……………...12 Best Practices 1……………...23 Round 2 Round 3 Round 1 • Before: this was done by reviewing long lists of information about evidence behind practice options • After TEAMbeta: this information will be provided in a clinically relevant way

  11. Methods: Building the Content, Defining the Specs • Pain Advisory Team (PAT) • 8 subject matter experts (variety of clinical perspectives) • Facilitated through collaboration platform (SharePoint) • Specification and Features Advisory Team (SFAT) • 4 subject matter experts (2 IT, 2 clinical) • Core Development Team (CDT) • Data abstraction from CPGs, systematic reviews, meta-analyses, etc. • Iterative prototyping with IT partner

  12. TEAMbeta Features • The map will parallel the structure of the International SCI Pain (ISCIP) classification system, which first identifies pain sub-types and highlights associated treatment options • Web-based (platform independent) software system • Interactivity enabled by zoom and pan functions

  13. TEAMbeta Features … • Overall shape and colour of treatment option will reflect a class of treatment • Illustrative icons link to underlying information (i.e. active/greyed-out = info available/not) • Icon colour-coding will illustrate status at-a-glance associated with the underlying information Gabapentin Tricyclic …

  14. TEAMbeta Features • By clicking on the appropriate icon, it will take you to the underlying information ?????? How-to Guidelines Gabapentin Evidence • There is level 1 evidence that Gabapentin and pregabalin improve neuropathic pain post SCI. • There is level 4 evidence that the anticonvulsant Gabapentin is more effective when SCI pain is <6 months than >6 months. • Source: SCIRE; This evidence is based on these articles

  15. Enabling the Delphi Process … • Icons to initiate voting and view past results • Enable culling over successive rounds Gabapentin Tricyclic …

  16. Lots of ideas – Long-term Development Gabapentin • Use gaming concepts (i.e., motivational rewards, competition, etc.). • Community of practice • Ideas emerging from PAT / SFAT Evidenc How-to Guidelines How-to Method of Administration: Oral Recommended Dose: cc mg bid Contraindications: safm dsein sdfdsoe dfs ssfs. Source: www.drquacky .com Congratulations!! You have completed the quest to examine and apply 5 “How-To” sections for pain treatments. You will receive 5 gold bars …

  17. Key Concept • Decision-making  Practice Change (Action) will be aided by placing information in an appropriate context. Comments?

More Related