scholarly journals The Capacity of Primary Care for Improving Evidence-Based Care: Early Findings From AHRQ’s EvidenceNOW

2018 ◽  
Vol 16 (Suppl 1) ◽  
pp. S2-S4 ◽  
Author(s):  
Sarah J. Shoemaker ◽  
Robert J. McNellis ◽  
Darren A. DeWalt
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Evidence Based Care

Interventions to promote the evidence-based care of children with ADHD in primary-care settings

2009 ◽  
Vol 9 (4) ◽  
pp. 477-487 ◽  
Author(s):  
Joshua M Langberg ◽  
William B Brinkman ◽  
Philip K Lichtenstein ◽  
Jeffery N Epstein
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Children With Adhd ◽  
Primary Care Settings ◽  
Evidence Based Care

Evidence-Based Care For Depression In Managed Primary Care Practices

1999 ◽  
Vol 18 (5) ◽  
pp. 89-105 ◽  
Author(s):  
Lisa V. Rubenstein ◽  
Maga Jackson-Triche ◽  
Jürgen Unützer ◽  
Jeanne Miranda ◽  
Katy Minnium ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Care Practices ◽  
Primary Care Practices ◽  
Evidence Based Care

Revolutionising the wound care pathway for patients with lower limb wounds

2020 ◽  
Vol 26 (5) ◽  
pp. 110-112
Author(s):  
Una Adderley
Keyword(s):  
Primary Care ◽  
Lower Limb ◽  
Care Pathway ◽  
Wound Care ◽  
Evidence Based ◽  
Common Condition ◽  
Evidence Based Care

Lower limb ulceration is common and costly, with evidence of variation in practice and under-use of evidence-based care. This has resulted in poor healing rates and exacerbated costs. Commissioning to achieve better organised care that supports early delivery of evidence-based interventions is needed to improve the management of this very common condition in community and primary care.

scholarly journals Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Trever Burgon ◽  
Linda Casebeer ◽  
Holly Aasen ◽  
Czarlota Valdenor ◽  
Diana Tamondong-Lachica ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
The United States ◽  
Physician Satisfaction ◽  
Evidence Based ◽  
Clinical Decisions ◽  
Care Providers ◽  
Evidence Based Care

BACKGROUND Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients. OBJECTIVE In this study, we introduced a novel tool, QualityIQ, and determined the extent to which it helps primary care physicians to align care decisions with the latest best practices included in the Merit-Based Incentive Payment System (MIPS). METHODS We developed the fully automated QualityIQ patient simulation platform with real-time evidence-based feedback and gamified peer benchmarking. Each case included workup, diagnosis, and management questions with explicit evidence-based scoring criteria. We recruited practicing primary care physicians across the United States into the study via the web and conducted a cross-sectional study of clinical decisions among a national sample of primary care physicians, randomized to continuing medical education (CME) and non-CME study arms. Physicians “cared” for 8 weekly cases that covered typical primary care scenarios. We measured participation rates, changes in quality scores (including MIPS scores), self-reported practice change, and physician satisfaction with the tool. The primary outcomes for this study were evidence-based care scores within each case, adherence to MIPS measures, and variation in clinical decision-making among the primary care providers caring for the same patient. RESULTS We found strong, scalable engagement with the tool, with 75% of participants (61 non-CME and 59 CME) completing at least 6 of 8 total cases. We saw significant improvement in evidence-based clinical decisions across multiple conditions, such as diabetes (+8.3%, <i>P</i>&lt;.001) and osteoarthritis (+7.6%, <i>P</i>=.003) and with MIPS-related quality measures, such as diabetes eye examinations (+22%, <i>P</i>&lt;.001), depression screening (+11%, <i>P</i>&lt;.001), and asthma medications (+33%, <i>P</i>&lt;.001). Although the CME availability did not increase enrollment in the study, participants who were offered CME credits were more likely to complete at least 6 of the 8 cases. CONCLUSIONS Although CME availability did not prove to be important, the short, clinically detailed case simulations with real-time feedback and gamified peer benchmarking did lead to significant improvements in evidence-based care decisions among all practicing physicians. CLINICALTRIAL ClinicalTrials.gov NCT03800901; https://clinicaltrials.gov/ct2/show/NCT03800901

Introduction

2020 ◽  
pp. 1-34
Keyword(s):  
Primary Care ◽  
Learning Disability ◽  
Enhanced Recovery ◽  
First Century ◽  
Evidence Based ◽  
Advanced Practice ◽  
Face To Face ◽  
Enhanced Recovery Pathways ◽  
Recovery Pathways ◽  
Evidence Based Care

This chapter provides an overview of the origins of orthopaedic and trauma nursing and care of the orthopaedic patient along the lifespan from birth to death in the twenty-first century. It explores contemporary healthcare in the context of a shift away from hospital-based care to more services being delivered in the community and primary care. It also looks at new ways of delivering care such as fast-track, enhanced recovery pathways and virtual or non-face-to-face clinics. Special attention has been given to supporting the person with a learning disability within orthopaedic and trauma settings. This chapter provides an update on standards and competencies for advanced practice roles and competencies within the field to optimize evidence-based care.

scholarly journals Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial

10.2196/31042 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e31042
Author(s):  
Trever Burgon ◽  
Linda Casebeer ◽  
Holly Aasen ◽  
Czarlota Valdenor ◽  
Diana Tamondong-Lachica ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
The United States ◽  
Physician Satisfaction ◽  
Evidence Based ◽  
Clinical Decisions ◽  
Care Providers ◽  
Evidence Based Care

Background Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients. Objective In this study, we introduced a novel tool, QualityIQ, and determined the extent to which it helps primary care physicians to align care decisions with the latest best practices included in the Merit-Based Incentive Payment System (MIPS). Methods We developed the fully automated QualityIQ patient simulation platform with real-time evidence-based feedback and gamified peer benchmarking. Each case included workup, diagnosis, and management questions with explicit evidence-based scoring criteria. We recruited practicing primary care physicians across the United States into the study via the web and conducted a cross-sectional study of clinical decisions among a national sample of primary care physicians, randomized to continuing medical education (CME) and non-CME study arms. Physicians “cared” for 8 weekly cases that covered typical primary care scenarios. We measured participation rates, changes in quality scores (including MIPS scores), self-reported practice change, and physician satisfaction with the tool. The primary outcomes for this study were evidence-based care scores within each case, adherence to MIPS measures, and variation in clinical decision-making among the primary care providers caring for the same patient. Results We found strong, scalable engagement with the tool, with 75% of participants (61 non-CME and 59 CME) completing at least 6 of 8 total cases. We saw significant improvement in evidence-based clinical decisions across multiple conditions, such as diabetes (+8.3%, P<.001) and osteoarthritis (+7.6%, P=.003) and with MIPS-related quality measures, such as diabetes eye examinations (+22%, P<.001), depression screening (+11%, P<.001), and asthma medications (+33%, P<.001). Although the CME availability did not increase enrollment in the study, participants who were offered CME credits were more likely to complete at least 6 of the 8 cases. Conclusions Although CME availability did not prove to be important, the short, clinically detailed case simulations with real-time feedback and gamified peer benchmarking did lead to significant improvements in evidence-based care decisions among all practicing physicians. Trial Registration ClinicalTrials.gov NCT03800901; https://clinicaltrials.gov/ct2/show/NCT03800901

Evidence-Based Care Models for Recognizing and Treating Alcohol Problems in Primary Care Settings: Part I

2001 ◽  
Author(s):  
Katherine E. Watkins ◽  
Harold Alan Pincus ◽  
Terri L. Tanielian
Keyword(s):  
Primary Care ◽  
Alcohol Problems ◽  
Evidence Based ◽  
Primary Care Settings ◽  
Care Models ◽  
Evidence Based Care

scholarly journals FRI0401 IMPLEMENTATION OF NICE GUIDELINES FOR OSTEOARTHRITIS IN PRIMARY CARE. FEASIBILITY STUDY OF JIGSAW-E IN SCOTLAND

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 799.1-799
Author(s):  
H. Frost ◽  
J. Cowie ◽  
T. Tooman ◽  
K. Dziedzic
Keyword(s):  
Primary Care ◽  
Phase 1 ◽  
Theoretical Domains Framework ◽  
Evidence Based ◽  
List Type ◽  
Musculoskeletal Health ◽  
Musculoskeletal Problem ◽  
Nice Guidelines ◽  
Research Questions ◽  
Evidence Based Care

Background:In the UK osteoarthritis (OA) is a common musculoskeletal problem with 8.75 million people seeking treatment in 20151.Evidence-based guidelines are available for the management of OA but implementation into routine daily practice remains complex. The Joint Implementation of Guidelines for Osteoarthritis in Western Europe (JIGSAW-E) model of care was developed and evaluated in England and implemented in Europe with an aim to optimise quality primary care for OA, support self-management and promote use of NICE guidelines2. The intervention includes:1. An OA guidebook for patients2. A model OA consultation for primary care3. Training for practitioners to deliver the model consultation4. Measures of quality care using an e-templateObjectives:To explore the feasibility of implementing the JIGSAW-E model to support people with OA in Scottish primary care.Research questions were informed by the Theoretical Domains Framework with an aim of:1) Exploring knowledge and beliefs about OA and its management in primary care.2) Identifying determinants for change; barriers and facilitators to implementing the JIGSAW-E model in Scotland.Methods:This qualitative study was comprised of 2 phases:Phase 1 included semi-structured interviews with health professionals (GPs and Extended Scope Practitioners) working in primary care. A purposeful sampling approach aimed to provide geographical and professional representation across Scotland. Interviews were recorded, transcribed and analysed using a theoretically-informed thematic framework approach.Phase 2 involved an engagement workshop that allowed for refinement and direct validation of emergent findings.Results:90 invitations were sent to practice managers in primary care. 14 participants from 10 practices across 6 Health Boards in Scotland were recruited for interviews, including 6 GPs and 8 Physiotherapy Extended Scope Practitioners (ESPs). 23 participants attended the engagement workshop (ESPs = 22, GPs =1). Thematic analysis indicated four main themes related to the research questions:1) Most participants were aware of NICE guidelines and believed they provided evidence-based OA care, and yet, for example, prescribing of co-codamol remained high. Physiotherapy ESPs were more likely to follow OA guidelines than GPs.2) Adaptations of the JIGSAW-E model are needed to support OA management in the Scottish context. For example, in addition to adapting the guidebook for local relevance, the e-template was met with resistance due to technological barriers.3) System-based barriers to implementation of the JIGSAW-E model included; lack of overall time for external training for practitioners; limited time in GP/patient appointments to consult and explain medication use and importance of physical activity. In part because patients usually present with multi-morbidities.4) The roll out of ESPs across Scotland in primary care provides a potential key for the delivery of sustainable evidence-based care in the Scottish health system.Conclusion:Overall, participants were in favour of the JIGSAW-E model in Scotland. Contextual adaptation of written materials would increase acceptance, ownership and usability by both practitioners and patients. The evolving role of GPs and ESPs is key to implementation, where ESPs provide leadership in the delivery of evidence-based care for patients with osteoarthritis.References:[1]Arthritis Research UK. State of Musculoskeletal Health 2017.[2]Dziedzic KS et al. Implementation of musculoskeletal Models of Care in primary care settings: Theory, practice, evaluation and outcomes for musculoskeletal health in high-income economies. Best practice & research Clinical rheumatology 2016;30(3):375-97.Acknowledgements:Thanks are due to the JIGSAW-E team, all participants, SISCC and EIT for funding.Disclosure of Interests:None declared

scholarly journals A qualitative study of processes used to implement evidence-based care in a primary care practice

2015 ◽  
Vol 32 (5) ◽  
pp. 578-583
Author(s):  
Jacquelyn A Huebsch ◽  
Thomas E Kottke ◽  
Paul McGinnis ◽  
Jolleen Nichols ◽  
Emily D Parker ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Care Practice ◽  
Evidence Based ◽  
Evidence Based Care
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