Do evidence-based guidelines improve the quality of care?

A European consensus conference on endometrial carcinoma was held in 2014 to produce multi-disciplinary evidence-based guidelines on selected questions. Given the large body of literature on the management of endometrial carcinoma published since 2014, the European Society of Gynaecological Oncology (ESGO), the European SocieTy for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly decided to update these evidence-based guidelines and to cover new topics in order to improve the quality of care for women with endometrial carcinoma across Europe and worldwide.

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Reducing Unwarranted Oncology Care Variation Across a Clinically Integrated Network: A Collaborative Physician Engagement Strategy

Journal of Oncology Practice ◽

10.1200/jop.18.00754 ◽

2019 ◽

Vol 15 (12) ◽

pp. e1076-e1084

Author(s):

Jon M. Richards ◽

Trever B. Burgon ◽

Diana Tamondong-Lachica ◽

Jacob D. Bitran ◽

Wilfredo L. Liangco ◽

...

Keyword(s):

Quality Of Care ◽

Cost Effective ◽

Simulated Patients ◽

Evidence Based ◽

Patient Level Data ◽

Patient Level ◽

Level Data ◽

Oncology Care ◽

Evidence Based Guidelines

PURPOSE: Addressing unwarranted clinical variation in oncology is a high priority for health systems that aspire to ensure consistent levels of high-quality and cost-effective care. Efforts to improve clinical practice and standardize care have proven challenging. Advocate Physician Partners undertook a patient simulation-based practice measurement and feedback project that was focused on breast and lung cancer to engage oncologists in the care standardization process. METHODS: One hundred three medical oncologists cared for online simulated patients using the Clinical Performance and Value platform, receiving feedback on how their care decisions compared with evidence-based guidelines and their peers. We repeated this process every 4 months over six rounds, measuring changes in quality-of-care scores. We then compared simulated patient results with available patient-level claims data. RESULTS: Over the course of the project, overall quality-of-care scores improved 11.9% ( P < .001). Diagnostic accuracy increased 6.7% ( P < .001) and correlated with improved treatment scores, including a nearly 10-percentage point increase in evidence-based chemotherapy regimens ( P = .009) and a 56% increase in addressing palliative needs for patients with late-stage disease ( P < .001). Unnecessary test ordering declined 25% ( P < .001). We compared these results with available patient data and observed concordance with the metastatic imaging workup order rate for early-stage breast cancer. As unnecessary workups declined in the simulations and became more closely aligned with evidence-based guidelines, we saw similar rates of decline in the patient-level data. CONCLUSION: This study demonstrates that an oncology care standardization system that combines simulated patients with serial feedback increases evidence-based and cost-effective clinical decisions in patient simulations and patient-level data.

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Improving quality of care for depression: the German Action Programme for the implementation of evidence-based guidelines

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzi089 ◽

2005 ◽

Vol 18 (2) ◽

pp. 113-119 ◽

Cited By ~ 23

Author(s):

Martin Härter ◽

Isaac Bermejo ◽

Günter Ollenschläger ◽

Frank Schneider ◽

Wolfgang Gaebel ◽

...

Keyword(s):

Quality Of Care ◽

Evidence Based ◽

Action Programme ◽

Evidence Based Guidelines

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Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment

Canadian Journal of Health Technologies ◽

10.51731/cjht.2021.35 ◽

2021 ◽

Vol 1 (2) ◽

Author(s):

Charlotte Wells ◽

Melissa Severn

Keyword(s):

High Risk ◽

Methodological Quality ◽

Clinical Effectiveness ◽

Conclusive Evidence ◽

Active Tuberculosis ◽

Tuberculosis Treatment ◽

Support Programs ◽

Evidence Based ◽

Evidence Based Guidelines

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment. Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment. The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high. The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.

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PENERAPAN PRAKTIK KEPERAWATAN BERBASIS BUKTI PURSED LIP BREATHING PADA PASIEN DENGAN PENYAKIT PARU OBSTRUKTIF KRONIK DI RUANG RSU PUSAT PERSAHABATAN JAKARTA

Jurnal Keperawatan Widya Gantari Indonesia ◽

10.52020/jkwgi.v2i2.857 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Seven Sitorus

Keyword(s):

Quality Of Care ◽

Pulmonary Disease ◽

Significant Influence ◽

Exercise Tolerance ◽

P Value ◽

Evidence Based ◽

Copd Exacerbation ◽

Before And After ◽

Evidence Based Nursing

Background: Chronic Obstruction Pulmonary Disease (COPD) is disease characterized by obstruction air flow in the breath not wholly reversible. One treatment can be done on improving exercise tolerance is exercise respiration as pursed lip breathing ( PLB ). Purse lip breathing is a techniques of breathing carried out to expelling air by creating power through in move closer /pursed lips. Purpose: provide an illustration of the application of the practice of evidence based nursing of pursed lip breathing in patients COPD in RSUP Persahabatan Jakarta. Method: the implementation of the practice of evidence based nursing pursed lip breathing is applied to 12 people sample ( 10 men and 2 women ) diagnosed with COPD exacerbation. Result: the majority of sex respondents is man as many as 10 ( 83,3 % ) persons and women as many as 2 ( 16,7 % ) a person .mean the age of respondents is 61,5 years ± 10.4 .mean the value of PEF ( Peak Expiratory Flow ), the value of the saturation oxygen , the value of respiratori rate before the intervention in a consecutive manner is 131.6 ± 44.6; 92.1 ± 2.44; 31.5 ± 2 . While value after the intervention is 175.0 ± 60.0; 97,1 ± 1.6; 22,6 ± 1.7 with P value = 0.001, α = 0.05. Conclusions: there are significant influence the application of pursed lip breathing between before and after the intervention in patients COPD. Advice: Intervention evidence based nursing can be applied to all patients COPD so reached the quality of care of nursing based on research

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Med-on-@ix

Clinical Technologies ◽

10.4018/978-1-60960-561-2.ch323 ◽

2011 ◽

pp. 974-994

Author(s):

In-Sik Na ◽

Max Skorning ◽

Arnd T. May ◽

Marie-Thérèse Schneiders ◽

Michael Protogerakis ◽

...

Keyword(s):

Quality Of Care ◽

Evidence Based Medicine ◽

Vital Signs ◽

Personal Data ◽

Clinical Findings ◽

Evidence Based ◽

Physician Shortage ◽

Virtual Presence ◽

Based Medicine

The aim of the project Med-on-@ix is to increase the quality of care for emergency patients by the operationalisation of rescue processes. The currently available technologies will be integrated into a new emergency telemedical service system. The aim is to capture all the necessary information comprising electrocardiogram, vital signs, clinical findings, images and necessary personal data of a patient at the emergency scene and transmit this data in real time to a centre of competence. This would enable a “virtual presence” on site of an Emergency Medical Services physician (EMS-physician, the German Notarzt). Thus, we can raise the quality of EMS in total and counter the growing problem of EMS-physician shortage by exploiting the existing medical resources. In addition, this system offers EMS-physicians and paramedics consultation from a centre of competence. Thereby referring to evidence-based medicine and ensuring the earliest possible information of the hospital.

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Indian nurses’ views on a collaborative model of best practices: Evidence-based practice, job satisfaction, learning environment, and nursing quality

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n9p87 ◽

2018 ◽

Vol 8 (9) ◽

pp. 87

Author(s):

Kaisa Bjuresäter ◽

Sister Tessy Sebastian ◽

Bhalchandra Kulkarni ◽

Elsy Athlin

Keyword(s):

Job Satisfaction ◽

Quality Of Care ◽

Clinical Practice ◽

Nursing Students ◽

Learning Environment ◽

Evidence Based Practice ◽

Positive Impact ◽

Evidence Based ◽

Collaborative Model

Introduction: This study is a part of a project aimed at implementing and evaluating the Collaborative Model of Best Practice, (CMBP) to promoting evidence-based practice (EBP) in health care contexts. The aim of the study was to assess nurses’ interest, attitudes, utilisation, and views on promotors of and resources related to EBP before and after taking part in the CMBP project, and to investigate their views on the CMBP in relation to collaboration between the academy and clinical practice, the earning environment, job satisfaction, and nursing quality.Methods: A descriptive, comparative design was used with pre- and post-test measurements. The Research Utilization Questionnaire (RUQ) and study-specific questions were distributed to ward nurses (n = 67) in a rural Indian hospital.Results: Most of the nurses thought that the CMBP had a positive impact on quality of care, on their attitudes to, interest in, and knowledge EBP, and on their job satisfaction. They also considered that the collaboration between the nursing college and clinical practice had a positive impact on the learning environment and that more resources were available at the end of the project.Conclusions: The CMBP project was an attempt to improve the quality of care for patients and the learning environment for nursing students and nurses on the project wards. The results indicated fulfilment of these goals, which strengthens the usability of the model. Implementation of EBP is challenging and requires long-lasting activities and comprehensive support from leaders and facilitators. More studies are needed in which EBP is systematically implemented, accomplished, evaluated, and reported.

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The Care Triangle: Determining the Gaps in the Management of Atopic Dermatitis

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2013.12119 ◽

2013 ◽

Vol 17 (4) ◽

pp. 276-282 ◽

Cited By ~ 5

Author(s):

Ashley O'Toole ◽

Bjorn Thomas ◽

Richard Thomas

Keyword(s):

Atopic Dermatitis ◽

Response To Treatment ◽

Care Process ◽

Evidence Based ◽

Previous Response ◽

Children And Young Adults ◽

The Individual ◽

Evidence Based Guidelines ◽

Based Medicine

Background: Atopic dermatitis (AD) is a chronic, relapsing, intensely pruritic dermatosis that usually affects infants, children, and young adults. The treatment of AD entails an individualized regimen that depends on the age of the patient, the stage and variety of lesions present, the sites and extent of involvement, the presence of infection, and the previous response to treatment. Objectives: To identify the evidence surrounding potential strategies for closing these gaps—ultimately improving the quality of care, the care process itself, and patient outcomes—and to encourage discussions that help develop tools to bridge the gap between suggested therapy and what is done by the patient. Methods: Review of the literature including searches on PubMed Central and Medline and in seminal dermatology texts. Results: There are several disconnections between the evidence-based guidelines in the management of AD, what the individual dermatologist recommends, and what the patient does. Conclusion: Applying the concept of the care triangle requires a balance of evidence-based medicine, the physician's experiences and the patient's needs and expectations in the decisions surrounding appropriate management of the disease.

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Article Commentary: Optimizing Surgical Care: A Contemporary Assessment of Temperature, Oxygen, and Glucose

The American Surgeon ◽

10.1177/000313481007600618 ◽

2010 ◽

Vol 76 (6) ◽

pp. 571-577 ◽

Cited By ~ 2

Author(s):

Ashley Dickinson ◽

Motaz Qadan ◽

Hiram C. Polk

Keyword(s):

Immune Response ◽

Quality Of Care ◽

Innate Immune Response ◽

Surgical Care ◽

Innate Immune ◽

Surgical Patients ◽

Evidence Based

Factors such as temperature, oxygen, and glucose have recently been implicated in the development of surgical sepsis by either promoting or attenuating protective components of the innate immune response. Reducing infective sequelae and the improvement of the quality of care of surgical patients is a top practice priority today. These factors and their associated effects are discussed through the examination of recent clinical and scientific studies to provide an up-to-date evidence-based review.

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The ACP Evidence-Based Guide to Complementary and Alternative Medicine

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2011/601271 ◽

2011 ◽

Vol 2011 ◽

pp. 1-2 ◽

Cited By ~ 2

Author(s):

Sungmi Lian

Keyword(s):

Quality Of Care ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Evidence Based Medicine ◽

Published Data ◽

Evidence Based ◽

Practice Of Medicine ◽

Based Medicine ◽

Complementary And Alternative

Complementary and alternative medicine (CAM) is no longer new terminology in the healthcare system but,evidence-based CAMis still an unfamiliar term. Evidence-based medicine, a practice of medicine based on the recommendation derived from a systematic, scientific study of published data, is accepted as the standard in the healthcare.ACP Evidence-Based Guide to Complementary and Alternative Medicineby Bradly Jacobs and Katherine Gundling is reviewed. Up-to-date reference books like theACP Evidence-Based Guide to Complementary and Alternative Medicineis an essential tool for improving quality of care when the providers aim to practice evidence-based medicine.

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