| Improving the translation of research into primary care practice: results of a national quality improvement demonstration project. | |
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MedLine Citation:
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PMID: 18677869 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There is widespread evidence of inadequate translation of research findings into primary care practice. Theoretically sound demonstrations of how health care organizations can overcomes these deficiencies are needed. A demonstration project was conducted from January 1, 2003, through June 30, 2006, to evaluate the impact of a multicomponent intervention and improvement models intended to enhance adherence to clinical practice guidelines across eight broad clinical areas. METHODS: The demonstration project involving 530 clinicians and staff members from 99 primary practices in 36 states entailed practice performance reports (audit and feedback), practice site visits for academic detailing and participatory planning, and network meetings for sharing 4 of "best practice" approaches. Data from electronic medical records (EMRs) of 847,073 patients were abstracted to identify 31 process and 5 outcome quality measures for prevention and treatment of cardiovascular disease and diabetes, cancer screening, adult immunization, respiratory and infectious disease, mental health and substance abuse, obesity and nutrition, safe medication prescribing in the elderly, and a summary measure, the Summary Quality Index (SQUID). RESULTS: The yearly adjusted absolute improvement in the SQUID was 2.43% (95% confidence interval [C.I.], 2.24%-2.63%). Clinically and statistically significant improvements occurred for 29 of the 36 quality measures, including all 5 outcome measures. DISCUSSION: The findings suggest that a multicomponent quality improvement intervention involving audit and feedback, academic detailing and participatory planning activities, and sharing of "best practice" approaches in practices with EMRs can have a robust impact in quality of care for Americans seen in primary care practices. |
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Authors:
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Steven Ornstein; Paul J Nietert; Ruth G Jenkins; Andrea M Wessell; Lynne S Nemeth; Heather L Rose |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Joint Commission journal on quality and patient safety / Joint Commission Resources Volume: 34 ISSN: 1553-7250 ISO Abbreviation: - Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-08-05 Completed Date: 2008-12-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101238023 Medline TA: Jt Comm J Qual Patient Saf Country: United States |
Other Details:
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Languages: eng Pagination: 379-90 Citation Subset: IM |
Affiliation:
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Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina, USA. ornstesm@musc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Benchmarking* Female Group Practice Humans Male Medical Audit* Middle Aged Organizational Case Studies Pilot Projects Primary Health Care* Private Practice Quality of Health Care* |
| Grant Support | |
ID/Acronym/Agency:
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1 U18 HS013716/HS/AHRQ HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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