Patient centered dissemination of evidence-based medicine - SHARE EBM

描述（由申请人提供）：循证实践的目标是根据最佳循证健康信息和患者的价值观和知情偏好做出临床决策。临床医生和患者在做出管理决策时可能无法及时获得高质量的比较有效性研究，从而导致对有效和无效护理的随意建议。利用称为决策辅助工具的共同决策工具提供有关管理方案及其利弊的证据，是应对传播循证卫生信息这一挑战的一种高度响应性和创新性解决方案。我们建议通过以下方式为传播循证健康信息的科学和实践做出贡献：1)在Mayo诊所（决策辅助研究专家）和临床系统改进研究所（ICSI）（实施专家）之间建立传播伙伴关系；2)开发一个理论支持的实施工具包，指导和支持初级保健实践对慢性病患者实施决策辅助。3)评估该工具包，以确定在服务农村、郊区和内城患者的实践中可持续实施的有效策略。在完成这些目标后，我们将有一种有效的方法，通过对慢性病患者的决策辅助，在护理点传播循证卫生信息，并形成了一种可持续的伙伴关系，以符合AHRQ目标和RFA-HS- 12-005的方式部署这种方法。

DESCRIPTION (provided by the applicant): The goal of evidence-based practice is to make clinical decisions based on both the best evidence-based health information and the values and informed preferences of the patient. Clinicians and patients may not have timely access to high-quality comparative effectiveness research when making management decisions, leading to haphazard recommendations of both effective and ineffective care. The provision of evidence about management options and their pros and cons using shared decision making tools called decision aids represents a highly responsive and innovative solution to the challenge of disseminating evidence-based health information. We propose to contribute to the science and practice of disseminating evidence-based health information by 1) building a dissemination partnership between Mayo Clinic, experts in decision aid research, and the Institute for Clinical Systems Improvement (ICSI), experts in implementation 2) developing a theory supported implementation toolkit to guide and support primary care practices on their implementation of decision aids for patients with chronic conditions, and 3) evaluating this toolkit to identify effective tactics for sustainable implementation within practices serving rural, suburban, and inner city patients. Upon completion of these aims we will have an effective approach to disseminating evidence-based health information at the point of care through decision aids for patients with chronic conditions, and formed a sustainable partnership to deploy this approach in a manner consistent with AHRQ objectives and RFA-HS- 12-005.