Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.
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DOI：
10.1186/s13012-014-0169-x
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发表时间：
2014-11-23
期刊：
影响因子：
--
通讯作者：
Cohen R
中科院分区：
文献类型：
--
作者：
Mold JW;Aspy CB;Smith PD;Zink T;Knox L;Lipman PD;Krauss M;Harris DR;Fox C;Solberg LI;Cohen R
四个以实践为基础的研究网络(PBRN)参与了一项研究，以确定网络是否可以通过利用早期采用者的实践来增加慢性肾脏疾病循证治疗指南的传播、实施和传播。在第一波研究中，来自四个PBRN的激励实践在6个月内接受了基线和定期绩效反馈、学术细节和每周实践促进。然后，每个第一波临床实践招募两个额外的实践(第二波)，这些实践接收绩效反馈和学术细节，并参与由第一波临床医生领导的每月本地学习协作。他们只接受了每月的练习促进。主要结果是遵循国家肾脏基金会肾脏疾病结果质量倡议指南中与初级保健相关的护理过程建议。绩效由病历摘要进行回顾确定。在干预前后测量实践优先顺序、改变能力和护理过程内容。干预后，第一波做法增加了ACEIs/ARB的使用，停用非类固醇抗炎药，检测贫血，检测和/或治疗维生素D缺乏症。大多数人能够为第二波招募两个额外的实践，第二波实践也增加了他们使用ACEI/ARB以及检测和/或治疗维生素D缺乏症的情况。在一些帮助下，早期采用者做法可以促进循证方法向其他做法的传播。PBRN处于有利地位，可以将这一过程复制到其他基于证据的创新中。本文的在线版本(doi：10.1186/s13012-0140169-x)包含补充材料，授权用户可以使用。
Four practice-based research networks (PBRNs) participated in a study to determine whether networks could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices. Motivated practices from four PBRNs received baseline and periodic performance feedback, academic detailing, and weekly practice facilitation for 6 months during wave I of the study. Each wave I practice then recruited two additional practices (wave II), which received performance feedback and academic detailing and participated in monthly local learning collaboratives led by the wave I clinicians. They received only monthly practice facilitation. The primary outcomes were adherence to primary care-relevant process-of-care recommendations from the National Kidney Foundation Kidney Disease Outcomes Quality Initiative Guidelines. Performance was determined retrospectively by medical records abstraction. Practice priority, change capacity, and care process content were measured before and after the interventions. Following the intervention, wave I practices increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices for wave II, and wave II practices also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency. With some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices. PBRNs are well-positioned to replicate this process for other evidence-based innovations. The online version of this article (doi:10.1186/s13012-014-0169-x) contains supplementary material, which is available to authorized users.
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影响因子：
2.9
作者：
Nagykaldi, Zsolt;Mold, James W.;Ford, Ann
通讯作者：
Ford, Ann
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
5.4
作者：
Nagykaldi, Zsolt;Mold, James W
通讯作者：
Mold, James W
影响因子：
7.2
作者：
Solberg, Leif I.;Crain, A. Lauren;Van de Ven, Andrew H.
通讯作者：
Van de Ven, Andrew H.
影响因子：
4.7
作者：
Lineker, Sydney C.;Bell, Mary J.;Zummer, Michel
通讯作者：
Zummer, Michel