scholarly journals Optimizing the management of osteoarthritis—Transitioning evidence-based guidelines into practical guidance for real-world clinical practice

2016 ◽  
Vol 45 (4) ◽  
pp. S1-S2 ◽  
Author(s):  
Jean-Yves Reginster ◽  
Cyrus Cooper
Keyword(s):  
Clinical Practice ◽  
Real World ◽  
Evidence Based ◽  
Practical Guidance ◽  
Evidence Based Guidelines

scholarly journals Wiki-Based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma: A New Paradigm in Sarcoma Evidence

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. J. Neuhaus ◽  
D. Thomas ◽  
J. Desai ◽  
C. Vuletich ◽  
J. von Dincklage ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Lessons Learned ◽  
Evidence Based ◽  
Adult Onset ◽  
New Paradigm ◽  
Software Application ◽  
Evidence Based Guidelines

In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.

scholarly journals Re-energising the way we manage change in healthcare: the case for soft systems methodology and its application to evidence-based practice

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hanna Augustsson ◽  
Kate Churruca ◽  
Jeffrey Braithwaite
Keyword(s):  
Real World ◽  
Soft Systems Methodology ◽  
Evidence Base ◽  
Learning Cycle ◽  
Evidence Based ◽  
Systems Methodology ◽  
Soft Systems ◽  
Implementation Effort ◽  
Evidence Based Guidelines ◽  
Taking Action

Abstract Background Updating, improving and spreading the evidence base for healthcare practices has proven to be a challenge of considerable magnitude – a wicked, multi-dimensional problem. There are many interlinked factors which determine how, why and whether any particular implementation effort or intervention succeeds. Soft Systems Methodology (SSM), strongly grounded in systems ideas and complexity science, offers a structured, yet flexible process for dealing with situations that are perceived as problematical and in need of improvement. The aim of this paper is to propose the use of SSM for managing change in healthcare by way of addressing some of the complexities. The aim is further to illustrate examples of how SSM has been used in healthcare and discuss the features of the methodology that we believe can be harnessed to improve healthcare. Discussion SSM is particularly suited for tackling real world problems that are difficult to define and where stakeholders may have divergent views on the situation and the objectives of change. SSM engages stakeholders in a learning cycle including: finding out about the problematical situation, i.e. the context in which the problem exists, by developing a rich picture of the situation; defining it by developing conceptual models and comparing these with the real world; taking action to improve it by deciding on desirable and feasible improvements; and implementing these in an iterative manner. Although SSM has been widely used in other sectors, it has not been extensively used in healthcare. We make the case for applying SSM to implementation and improvement endeavours in healthcare using the example of getting clinicians at the hospital level to use evidence-based guidelines. Conclusion Applying SSM means taking account of the multi-dimensional nature of care settings, and dealing with entrenched and unique contexts, cultures and socio-political ecosystems – precisely those that manifest in healthcare. There are gains to be made in appreciating complexity and facilitating contextualization of interventions, and by approaching improvements in an iterative learning cycle.

scholarly journals Are Evidence-Based Guidelines Reflected in Clinical Practice? An Analysis of Prospectively Collected Data of the Italian Thyroid Cancer Observatory

Thyroid ◽  
2017 ◽  
Vol 27 (12) ◽  
pp. 1490-1497 ◽  
Author(s):  
Livia Lamartina ◽  
Cosimo Durante ◽  
Giuseppe Lucisano ◽  
Giorgio Grani ◽  
Rocco Bellantone ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Evidence Based ◽  
Evidence Based Guidelines

scholarly journals Dietitians' perceptions and experience of blenderised feeds for paediatric tube-feeding

2016 ◽  
Vol 102 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Janis Armstrong ◽  
Elaine Buchanan ◽  
Hazel Duncan ◽  
Kathleen Ross ◽  
Konstantinos Gerasimidis
Keyword(s):  
Clinical Practice ◽  
Tube Feeding ◽  
Infection Risk ◽  
Previous Experience ◽  
Evidence Based ◽  
Web Based ◽  
Commercial Feeds ◽  
Evidence Based Guidelines ◽  
Professional Guidelines

ObjectiveThere is an emerging interest in the use of blenderised food for tube-feeding (BFTF). This survey explored paediatric dietitians' perceptions and experiences of BFTF use.DesignA web-based questionnaire was distributed to the Paediatric group of the British Dietetic Association. The survey captured dietitians' personal opinions and experience supporting children on BFTF, and the perceptions of carers.ResultsOf the 77 respondents, 19 were aware of professional guidelines and 63 had never received training on BFTF. Thirty-four would not recommend BFTF and 11 would advise against its use; yet 43 would recommend it to supplement commercial feeds. Fifty-seven would change their perception about BFTF if there were evidence-based guidelines. Forty-four would feel confident to support a patient using BFTF. Forty-three had previous experience supporting a patient with BFTF. The main concerns perceived by dietitians, pertinent to the use of BFTF, were nutritional inadequacy (n=71), tube blockages (n=64) and increased infection risk (n=59) but these were significantly higher than those experienced by themselves in clinical practice (p<0.001 for all three). A reduction in reflux and vomiting and increased carer involvement were the main perceived and observed benefits by both dietitians and carers.ConclusionsThe use of these feeds for tube-fed children is increasingly being seen as a viable choice. Dietitians experienced significantly fewer issues with the use of BFTF in clinical practice compared with their self-reported apprehensions in the survey. Well-controlled studies are now needed to objectively assess the benefits, risks, costs and practicality of BFTF.

scholarly journals Public health for paediatricians: Fifteen-minute consultation on addressing child poverty in clinical practice

2020 ◽  
pp. edpract-2020-319636
Author(s):  
Guddi Singh ◽  
Hannah Zhu ◽  
C Ronny Cheung
Keyword(s):  
Public Health ◽  
Clinical Practice ◽  
Young People ◽  
Child Health ◽  
Health Professionals ◽  
Child Poverty ◽  
Evidence Based ◽  
Children And Young People ◽  
Clinical Consultation ◽  
Practical Guidance

Paediatricians and other child health professionals have a key role in identifying, preventing or mitigating the impacts of poverty on child health. Approaching a problem as vast and intractable as poverty can seem daunting. This article will outline how social determinants impact child health, and provide practical guidance on how to address this problem through a public health lens. The aim is to give frontline practitioners a straightforward, evidence-based framework and practical solutions for tackling child poverty, across three levels: (1) the clinical consultation; (2) the clinical service for the population of children and young people we serve and (3) with a broader policy and social view.

Using Web-Enabled Technology to Promote the Adoption of Practice Guidelines

2011 ◽  
pp. 172-185
Author(s):  
James G. Anderson ◽  
Linda L Casebeer ◽  
Robert E. Kristofco ◽  
Angela S. Carillo
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Rapid Expansion ◽  
Evidence Based ◽  
Information And Communications Technologies ◽  
Physician Uncertainty ◽  
Educational Applications ◽  
Evidence Based Guidelines ◽  
Based Medicine

The rapid expansion of scientific knowledge brings increased physician uncertainty in clinical decisionmaking. Clinical practice guidelines have been developed to reduce physician uncertainty. The broad movement to develop and disseminate clinical practice guidelines is rooted in evidence-based medicine. Although the development and dissemination of evidence-based guidelines has increased dramatically over the past decade, studies indicate serious deficiencies in the adoption of guidelines into practice. Developments such as client/server networks, the Internet, and the World Wide Web are rapidly expanding potential educational applications for information and communications technologies and the capacity for introducing strategies to promote guideline adoption. Web-enabled computer technology can enhance the capability of healthcare information systems to reduce variation in clinical decisionmaking.

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