Uptake Of Clinical Guidelines Research Articles

Development and uptake of the National Heart Foundation of Australia Smart Heart Guideline App

Abstract Background Many organisations have developed Smartphone mobile applications (apps) to improve access and uptake of clinical guidelines, including the European Society of Cardiology and the American Heart Foundation. The National Heart Foundation of Australia publish clinical guidelines in collaboration with the Cardiac Society of Australia and New Zealand. We aimed to develop an app for three national guidelines: 1) the Australian clinical guidelines for the prevention and detection of atrial fibrillation 2018; 2) the Australian clinical guidelines for the detection and management of heart failure in Australia 2018; and 3) the Australian clinical guidelines for the management of acute coronary syndromes 2016. Purpose To develop a mobile app for Australian health professionals to improve access and uptake of national cardiac clinical guidelines. Methods A national health professional mobile app online survey was developed and distributed in 2017. Survey items included the frequency of searching for information about the prevention or management of cardiovascular disease, the methods of searching, and the likelihood of using an Australian-specific mobile app to access clinical guidelines. Following analysis of survey responses, a software developer was contracted to develop the app, which included user-testing. The Smart Heart Guidelines App was registered with the regulatory body in Australia, the Therapeutic Goods Administration, and made freely available from October 2019 on iOS and Android operating systems. The app was promoted using electronic direct mail, social media techniques (Twitter and LinkedIn), on our organisation's website and via printed flyers and materials at regional and national event stands at conferences. Data from the Apple App Store was analysed between 1 October 2019 – 1 October 2020 to evaluate app use. Results The health professional survey (respondents n=504; nurses 39%, allied health professionals 26%; GP/cardiologist 9%; researcher 8%; other 18%) showed most (n=447; 89%) reported accessing the Heart Foundation's resources electronically. The majority (n=355; 70%) reported they would be likely to use an Australian-specific app. Data from the Apple App Store indicated over 30,300 impressions (the number of times the Smart Heart App appeared in an App Store search) during the first year the app was available. This resulted in approximately 4,400 app downloads, with consistent “search-to-download rates” throughout the year (monthly average rate 22%). Of the downloads, 3,200 (82%) were a direct result of searching for the Smart Heart App, indicating promotional activities were effective. Conclusion Development of the Smart Heart Guideline App in Australia was indicated by health professionals to improve access to national cardiac clinical guidelines. Consistent app downloads and use during the first-year support further research, development, promotion, and evaluation of the app. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The National Heart Foundation of Australia

2239-PUB: Best Practices for Implementing Diabetes Prevention in Health Care Settings

One in 3 adults in the U.S. has prediabetes and 90 percent don’t even know they have it. If left untreated or treated with usual care, many will go on to develop type 2 diabetes. The Centers for Disease Control and Prevention’s National Diabetes Prevention Program (DPP) was created in 2010 to address the increasing burden of prediabetes and type 2 diabetes in the United States. Despite the demonstrated effectiveness of an intensive lifestyle invention program, there are still millions of undiagnosed and untreated individuals with prediabetes. Identification of prediabetes and referral of eligible adults to a lifestyle change program is recommended in both the ADA and USPSTF clinical guidelines and standards of care. However, only a minority of clinicians are systematically addressing prediabetes in their patient population or referring their patients to a lifestyle change program. Although existing research has evaluated the uptake of clinical guidelines regarding diabetes prevention and the availability of coverage for lifestyle change programs, there is a gap in collecting and sharing best practices for building a diabetes prevention strategy that includes the CDC’s National DPP lifestyle change program. The AMA convened a diverse group of leading health care organizations that were successful in establishing system-based strategies. This session will describe a best practice implementation framework for health systems to consider when establishing or expanding a diabetes prevention strategy and engaging with clinical champions to improve identification and treatment of patients with prediabetes. Disclosure J. Williams: None. N. Sachdev: None. T. Moin: None. O. Duru: None.

Guideline use behaviours and needs of primary care practitioners in China: a cross-sectional survey

ObjectivesClinical guidelines have been recognised as an effective way to improve healthcare performance. However, little is known about the uptake and implementation of guidelines by general practitioners in China. The...

Feasibility of applying review criteria for depression and osteoporosis national guidance in primary care

Data on the uptake of clinical guidelines into practice are essential to guide and evaluate quality improvement interventions. Organizations responsible for service specification, monitoring and improvement need to consider the practicality of and trade-offs made in different data collection methods. We examined the feasibility of deriving and applying review criteria for clinical guidelines in English primary care. We selected two sets of guidance, on osteoporosis and depression, and used a consensus process to derive review criteria. We manually extracted data on adherence to review criteria from patient records in 20 general practices from three NHS primary care trusts in northern England. We compared the relative utility of extracted data with that of routinely available data, summarizing feasibility using what we termed a Resource Ratio. Of 53 proposed review criteria we assessed, 41 were judged clinically important, valid, relevant and measurable. Thirty-one could be assessed in 10% or more of sampled patients, whereas 15 could be readily extracted (resource ratio of 15 or less). Only eight met all desirable attributes for use as review criteria. Resource ratios correlated poorly with local stakeholders' prior views on feasibility of data collection. We observed wide variations in compliance with review criteria, with notably low levels among self-care standards. A minority of guideline recommendations were suitable for review criteria development, fewer still when using routinely available data. Local stakeholders tend to underestimate the actual resource requirements of data collection. Although improved design and use of clinical records may facilitate measurement of adherence to recommended practice, detailed assessments are still likely to rely upon some degree of manual data collection in the foreseeable future.

Clinical Decision Support Systems in Psychiatry in the Information Age

Clinical decision support systems (CDSSs) are active knowledge systems that use two or more items of patient data to generate case-specific advice. They were developed to improve health-care quality. There is evidence that they can be a valuable tool in fostering the process of dissemination and uptake of clinical guidelines that, in turn, can improve clinical decision-making and outcomes. The present paper will explore why, despite this potential, CDSSs have not been extensively used in psychiatry. There is an abundant literature that explores the barriers to the development and implementation of information technology in health. This can be understood as related to clinician, organizational, cultural and technological factors. Certain characteristics of the clinical discipline of psychiatry present an additional barrier, although diagnostic systems appear to have gained a level of acceptance.

The implementation and uptake of clinical guidelines in obstetrics and gynaecology

The Obstetrician & GynaecologistVolume 3, Issue 2 p. 93-95 The implementation and uptake of clinical guidelines in obstetrics and gynaecology Allan Templeton FRCOG, Corresponding Author Allan Templeton FRCOG Chairman Guidelines and Audit Committee, RCOG 27 Sussex Place, Regent's Park, London NW1 4RG, UKGuidelines and Audit Committee, RCOG 27 Sussex Place, Regent's Park, London NW1 4RG, UKSearch for more papers by this authorMark Charny MB BChir, Mark Charny MB BChir Director former National Centre for Clinical Audit, Department of HealthSearch for more papers by this authorJane Thomas MRCOG, Jane Thomas MRCOG Director Clinical Effectiveness Support Unit, RCOGSearch for more papers by this authorCharnjit Dhillon, Charnjit Dhillon Clinical Governance and Standards Manager RCOGSearch for more papers by this authorSurvey and Writing Committee, Survey and Writing CommitteeSearch for more papers by this author Allan Templeton FRCOG, Corresponding Author Allan Templeton FRCOG Chairman Guidelines and Audit Committee, RCOG 27 Sussex Place, Regent's Park, London NW1 4RG, UKGuidelines and Audit Committee, RCOG 27 Sussex Place, Regent's Park, London NW1 4RG, UKSearch for more papers by this authorMark Charny MB BChir, Mark Charny MB BChir Director former National Centre for Clinical Audit, Department of HealthSearch for more papers by this authorJane Thomas MRCOG, Jane Thomas MRCOG Director Clinical Effectiveness Support Unit, RCOGSearch for more papers by this authorCharnjit Dhillon, Charnjit Dhillon Clinical Governance and Standards Manager RCOGSearch for more papers by this authorSurvey and Writing Committee, Survey and Writing CommitteeSearch for more papers by this author First published: 24 January 2011 https://doi.org/10.1576/toag.2001.3.2.93Citations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume3, Issue2April 2001Pages 93-95 RelatedInformation

A national audit to monitor and promote the uptake of clinical guidelines on the management of diabetes in pregnancy.

Seeks to assess maternity care for women with Type 1 diabetes in relation to recommendations in a national clinical guideline using a criterion-based clinical audit. The audit covered all 22 consultant-led maternity units in Scotland, focusing on 268 completed pregnancies in women with Type 1 diabetes. Results are presented and discussed. Concludes that a national audit to monitor the impact of clinical guidelines proved feasible. Antenatal care is organised in line with guideline recommendations but there is lower provision of formal prepregnancy care. Pregnancy planning and periconceptual care fall short of recommendations but care during pregnancy is meticulous. Adverse pregnancy outcomes remain commoner than in non-diabetic pregnancies.

Erratum

This article has been withdrawn as it was published elsewhere and accidentally duplicated. The original article can be seen here: 10.1108/14664100010332991. When citing the article, please cite: Gillian C. Penney, Donald Pearson, (2000), “A national audit to monitor and promote the uptake of clinical guidelines on the management of diabetes in pregnancy”, British Journal of Clinical Governance, Vol. 5 Iss 1 pp. 28 - 34.