Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 9609491

Implementing clinical guidelines: how can informatics help?

L Duff·A Casey
View original source ↗Export metadata ↓

Abstract

Clinical guidelines are heralded as a positive contribution to improving quality of care and ensuring the effectiveness of care. From the perspective of the health services researcher, the authors propose a model of how informatics can support the implementation of clinical guidelines and their integration into systems for decision support and clinical audit. Each element of the model is discussed in turn.

Explore related subjects

Health Plan ImplementationMedical InformaticsPractice Guidelines as TopicJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

L Duff, A Casey. Implementing clinical guidelines: how can informatics help?. https://doi.org/10.1136/jamia.1998.0050225

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2006

The last Senior Medical Inspector of Factories and his place in the history of occupational health.

BACKGROUND: Apart from a few industrialists with senses of enlightened self-interest and of ethics, 19th century Occupational Health (OH) in the United Kingdom was essentially in the care of Her Majesty's Factory Inspectorate (HMFI). Two World Wars drew attention to the special health and efficiency needs of workers in the armaments industry, but it required the climate of a Welfare State after the Second for more general provision to be considered. A number of committees made recommendations for enhancing OH that were not implemented, and it was not until 1972 that a political will developed to enhance the State's provision. As a result of a far-sighted senior civil servant, a remarkable Senior Medical Inspector was in post, ready and willing to assist in bringing about change. METHODS: Published official materials have been reviewed in the light of the author's observation of events and persons from 1967 onwards. RESULTS: For a few years, as a consequence of a political will, academic, corporate, and governmental OH burgeoned in Britain, but with a decline in the economy and political change favoring deregulation, it underwent regression. CONCLUSIONS: Any number of committees may meet to discuss OH provision but their reports will moulder until there is a will for implementing their recommendations, at which the requisite funds and persons materialize to establish institutions. When the political climate changes, it will not be difficult to find persons who for a consideration will assist in their demolition.

Health Plan Implementation↗
PubMed2006

Strategies for dissemination and implementation of guidelines.

Interventions designed to effectively implement and disseminate clinical practice guidelines (CPG) fall into different categories. A systematic review of the effectiveness and costs of different guideline development, dissemination and implementation strategies was recently undertaken by the Health Technology Assessment (HTA) Programme in UK. Overall, the majority of comparisons reporting dichotomous process data observed improvement in care. However, there was considerable variation in the observed effects both within and across interventions. Evaluation studies provided evidence that adherence of physicians to CPG is a strong predictor of the stroke outcome. Cochrane Collaboration performed a systematic review including studies published up to 2004 that compared integrated clinical pathways (ICP) for stroke care with standard medical care. They found no significant difference between ICP and control groups in terms of death or discharge destination. Patients managed with a care pathway were more dependent at discharge, less likely to suffer a urinary tract infection, less likely to be readmitted and more likely to have neuroimaging. A positive effect was reported from a validation study of a multifaceted strategy for stroke care ICP implementation in Italy.

Health Plan Implementation↗