A qualitative study of processes used to implement evidence-based care in a primary care practice.
Fam Pract
; 32(5): 578-83, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26089298
ABSTRACT
BACKGROUND:
Evidence-based guidelines for care of coronary heart disease patients are not fully implemented. Primary care practices provide most of the care for these patients.OBJECTIVE:
To learn how providers and staff in a busy primary care practice implement interventions to provide evidence-based care of coronary heart disease patients.METHODS:
We conducted a qualitative analysis of the responses to open-ended questions in nine electronically administered bimonthly surveys of key physicians, clinic staff and managers in the practice.RESULTS:
Ten to 16 (mean=12.3) personnel responded to each survey. Nearly 30% were physicians and 40.5% were clinic staff. Four major themes emerged from the qualitativeanalysis:
(i) giving data about not-at-goal patients to providers for care plan development; (ii) developing team roles and defining tasks; (iii) providing patient care and implementing care plans and (iv) providing technology support to generate useful, accurate data. The frequency that the subthemes were mentioned varied from survey to survey, but their mention persisted over the entire time of all nine surveys.CONCLUSIONS:
Developing a system for implementing evidence-based care involves considerations of roles and teamwork, technology use to develop a patient registry and obtain needed clinical data, care processes for pre-visit planning, and between-visit care management. A registered nurse care manager is a central figure in implementing and sustaining the process. Implementing evidence-based guidelines is an ongoing process of revision, retraining and reinforcement.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Medicina Baseada em Evidências
/
Doença das Coronárias
Tipo de estudo:
Guideline
/
Qualitative_research
Limite:
Humans
Idioma:
En
Revista:
Fam Pract
Ano de publicação:
2015
Tipo de documento:
Article