The Logic Behind a Multimethod Intervention to Improve Adherence to Clinical Practice Guidelines in a Nationwide Network of Primary Care Practices

University of Southern California, USA.
Evaluation & the Health Professions (Impact Factor: 1.91). 04/2006; 29(1):65-88. DOI: 10.1177/0163278705284443
Source: PubMed


The gap between evidence-based guidelines for clinical care and their application in medical settings is well established and widely discussed. Effective interventions are needed to help health care providers reduce this gap. Whereas the development of clinical practice guidelines from biomedical and clinical research is an example of Type 1 translation, Type 2 translation involves successful implementation of guidelines in clinical practice. This article describes a multimethod intervention that is part of a Type 2 translation project aimed at increasing adherence to clinical practice guidelines in a nationwide network of primary care practices that use a common electronic medical record (EMR). Practice performance reports, site visits, and network meetings are intervention methods designed to stimulate improvement in practices by addressing personal and organizational factors. Theories and evidence supporting these interventions are described and could prove useful to others trying to translate medical research into practice. Additional theory development is needed to support translation in medical offices.

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Available from: Lynne S. Nemeth
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    • "Family practice is an ideal setting for most chronic disease prevention and screening (CDPS) actions and there are several evidence-based tools and strategies available to improve CDPS, but they are inconsistently applied [3-17]. Examples include the use of electronic medical records (EMR), reminder systems [11], evidence-based guidelines and tools for CDPS actions, patient targeted interventions such as self-management tools [8-10,12,13], and practice-based quality improvement strategies such as practice facilitators [4,6,7,14-16,18]. "
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