Demonstrating, testing, and disseminating a sustainable model for academic detailing programs

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Abstract Health care systems are seeking to close the gap between actual medical practice and optimal clinical decision making as guided by evidence-based medicine. Academic detailing (AD), direct outreach education from trained professionals to front line clinicians, has been proven effective in scores of research studies. Many health care systems have expressed interest in implementing AD, but lack the expertise and resources to design a program, train personnel to deliver the outreach education, and evaluate the program’s impact. The National Resource Center for Academic Detailing (NaRCAD), supported by AHRQ, has developed a curriculum that has been used to train over 400 health professionals in the techniques of AD and has worked with dozens of health care systems and public health department to support the planning and implementation of AD programs. At present, however, these organizations still rely on direct assistance from NaRCAD to receive this training and support. We propose a demonstration project that will develop, test, and disseminate a set of tools that will provide health care systems with the capacity to implement and sustain AD programs. The first step will be a comprehensive survey that will both characterize in detail the current scope and structure of AD programs and serve as a needs assessment for health care systems seeking to use this approach. We will then work with experienced academic detailers from leading programs to develop and field test a train-the-trainer curriculum, building on our existing training program, to yield a cohort of graduates able to initiate and independently sustain training in the techniques of academic detailing. As these new trainers prepare additional academic detailers, we will disseminate the train-the-trainer curriculum to health care systems nationally. In addition, we will collaborate with several of the larger health care systems currently using AD to develop an evaluation guide, taking advantage of NaRCAD’s positioning in a research group with expertise in analysis of multiple types of healthcare data. The evaluation guide will be designed for use by health care systems newly implementing or seeking to assess and improve their AD programs and will allow systems to evaluate academic detailers on their knowledge, proficiency, and impact on medical outcomes. Finally, we will combine the findings from this demonstration project into a comprehensive toolkit that we will disseminate to health care systems broadly, building on AHRQ’s ongoing Comparative Health System Performance Initiative that seeks to support learning health systems. Health care systems will be able to use the toolkit to build capacity to independently design an AD program, train detailers, and evaluate their skills and impact, with support available as needed to ensure that these efforts are conducted with the highest quality.