Leveraging a national academic detailing resource to improve clinical decisions

描述（由申请人提供）：高效治疗在临床实践中往往未得到充分使用，一些常用治疗无效甚至有害。许多研究已经证明，如果临床医生能够更全面地将证据应用于他们的医疗决策，医疗服务和患者结局可能会有所改善。Academic Detailing是对临床医生的直接教育推广，以简洁，清晰，公正和用户友好的格式为他们提供信息，重点是改善患者预后所需的实用信息。学术细节最初是在AHRQ的前身机构的支持下开发的，已经在数十项临床试验中进行了测试，这些试验证明了其改善临床医生行为的能力。2010年，布里格姆妇女医院的一个团队建立了国家学术细节资源中心（NaRCAD），作为AHRQ iADAPT倡议的一部分，以更广泛地传播循证实践。在过去的3年中，NaRCAD与来自美国各地的组织合作，帮助实施和扩大学术细节和相关教育推广计划，以改善患者护理和结果。该委员会对教育工作者进行了学术细节技术方面的培训，为公共和私人方案进行了数据分析，以寻求改善护理的机会，为制定和编辑干预措施中使用的教育文件提供了援助，就新的学术细节方案的规划向各组织提供了咨询意见，并建立了一个正在使用学术细节和相关战略的组织的持续网络。我们现在提议维持和扩大NaRCAD的影响范围。我们将继续为寻求建立或扩大学术细节计划的利益相关者提供多方面的支持。除了上述服务外，我们还将指导如何解释未来几年以患者为中心的结果研究中出现的新信息。我们将继续提供学术细节技术的培训课程，现在将扩大地理范围，每年在波士顿以外举办一门课程。我们还将开发一个关于管理学术细节计划的新课程，以回应我们在NaRCAD前3年参与的利益相关者的反馈。与代表一系列患者人群和医疗机构的组织建立了四种模式合作伙伴关系，每个项目年一种：疗养院患者、亚拉巴马安全网初级保健机构中的患者、国防部卫生系统中的患者以及由旧金山弗朗西斯科公共卫生部服务的高风险患者。通过将NaRCAD先前成功活动的延续和强化与涉及不同利益相关者的具体新举措相结合，我们拟议的工作将大大增加学术细节和其他外展教育干预措施的覆盖面，从而广泛改善医疗保健服务和患者结局。

DESCRIPTION (provided by applicant): Highly effective treatments are often underused in clinical practice, and some commonly used treatments are ineffective or even harmful. Many studies have documented the potential improvements in healthcare delivery and patient outcomes if clinicians were able to more completely apply the evidence to their medical decisions. Academic Detailing is direct educational outreach to clinicians, providing them with information in a concise, clear, impartial, and user-friendly format that focuses on practical information needed to improve patient outcomes. Originally developed with support from AHRQ's predecessor agency, Academic Detailing has been tested in scores of clinical trials that have proven its ability to improve clinician behavior. In 2010 a team at Brigham and Women's Hospital established the National Resource Center for Academic Detailing (NaRCAD) as part of AHRQ's iADAPT initiative to disseminate evidence-based practices more widely. Over the past 3 years NaRCAD has worked with organizations from around the US to help implement and expand programs of Academic Detailing and related educational outreach to improve patient care and outcomes. NaRCAD has trained educators in the techniques of Academic Detailing, conducted data analysis for public and private programs seeking to identify opportunities for care improvement, provided assistance with development and editing of educational documents to be used in interventions, advised organizations on the planning of new Academic Detailing programs, and created an ongoing network of organizations that are using Academic Detailing and related strategies. We now propose to sustain and expand the reach of NaRCAD. We will continue to provide multiple dimensions of support to stakeholders seeking to establish or augment Academic Detailing programs. In addition to the services described above we will provide guidance on how to interpret the new information that will emerge from patient-centered outcomes research over the coming years. We will continue to provide training courses in the techniques of Academic Detailing, and will now expand the geographic scope by conducting one course per year outside of Boston. We also will develop a new course on managing an Academic Detailing program, responding to feedback from stakeholders with whom we have engaged in the first 3 years of NaRCAD. Four model partnerships, one for each project year, have been developed with organizations representing a range of patient populations and healthcare settings: nursing home patients, patients in safety net primary care settings in Alabama, patients in the Department of Defense health system, and high-risk patients served by the San Francisco Department of Public Health. By combining a continuation and intensification of NaRCAD's successful prior activities with specific new initiatives involving diverse stakeholders, our proposed work will dramatically increase the reach of Academic Detailing and other outreach educational interventions, allowing for broad-based improvement in healthcare delivery and patient outcomes.