Changing doctors' behaviours: an educational program to disseminate a new clinical pathway for the hospital management of hip fractures in elderly patients in the Lazio Region, Italy

Ciaschi, Alma; Caprara, Andréa; Gillespie, Francesca; Furnari, Giacomo; Mamede, Sílvia

doi:10.1111/j.1365-2753.2010.01496.x

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…The argumentation of this Editorial Introduction and the 41 papers of this issue [43–83] together constitute the 13th thematic edition of the Journal of Evaluation in Clinical Practice , building upon the work of the previous 12 [12–23]. We have entitled this year's edition ‘Models in the Balance: Evidence‐based Medicine versus Evidence‐informed Individualised Care’, because we believe that the time is now right to institute a debate on the need to progress towards the formulation of personalized models of care informed , but not based , on the E of EBM, representing a Hegelian shift in understanding following some 20 years of intensive philosophical and clinical argumentation on the nature of knowledge and action in clinical practice.…”

Section: Resultsmentioning

confidence: 99%

Models in the balance: evidence‐based medicine versus evidence‐informed individualized care

Miles

Loughlin

2011

Evaluation Clinical Practice

106

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Section: Resultsmentioning

confidence: 99%

Models in the balance: evidence‐based medicine versus evidence‐informed individualized care

Miles

Loughlin

2011

Evaluation Clinical Practice

106

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“…All of the planned series of interventions—educational, system change, data feedback—and having a site champion were based on prior reviewed QI literature 37–39. Each site visit was an important conduit in developing a working collaborative relationship to change attitudes towards the use of HCTs.…”

Section: Discussionmentioning

confidence: 99%

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

et al. 2020

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BackgroundBlunt head injury is a common pediatric injury and often evaluated in general emergency departments. It estimated that 50% of children will undergo a head computed tomography (CT), often unnecessarily exposing the child to ionizing radiation. Pediatric academic centers have shown quality improvement (QI) measures can reduce head CT rates within their emergency departments. We aimed to reduce head CT utilization at a rural community emergency department.MethodsChildren presenting with a complaint of blunt head injury and were evaluated with or without a head CT. Head CT rate was the primary outcome. We developed a series of interventions and presented these to the general emergency department over the duration of the study. The pre and intervention data was analysed with control charts.ResultsThe preintervention and intervention groups consisted of 576 children: 237 patients with a median age of 8.0 years and 339 patients with a median age of 9.00 years (p=0.54), respectively. The preintervention HCT rate was 41.8% (95% CI 35.6% to 48.1%) and the postintervention rate was 27.7% (95% CI 23.3% to 32.7%), a decrease of 14.1% (95% CI 6.2% to 21.9%, p=0.0004). During the intervention period, there was a decrease in HCT rate of one per month (OR 0.96, 95% CI 0.92 to 1.00, p=0.07). The initial series of interventions demonstrated an incremental decrease in HCT rates corresponding with a special cause variation.ConclusionThe series of interventions dispersed over the intervention period was an effective methodology and successfully reduced HCT utilisation among children with blunt head injury at a rural community emergency department.

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“…[1][2][3] Health outcomes research has previously focused on chronic disease states and disease states that contribute significantly to total healthcare costs such as asthma, coronary heart disease and diabetes. [4][5] In this study, we looked at the application and utility of clinical pathways in the management of five infectious diseases: varicella, acute bacillary dysentery, measles, scarlet fever and rubella. The details and results are reported as follows.…”

Section: Introductionmentioning

confidence: 99%

Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella

Xu¹,

Qin²,

Zhao³

et al. 2014

N A J Med Sci

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In order to explore the clinical pathways that fit the actual situation of our country and department of infectious diseases, an analysis was performed to evaluate the effectiveness of clinical pathways for varicella, acute bacillary dysentery, measles, scarlet fever and rubella when compared with traditional standard medical care. Using a retrospective comparative study design, varicella, acute bacillary dysentery, measles, scarlet fever and rubella patients who were managed on a clinical pathway (clinical pathway group) were compared with a retrospective group of patients who received traditional medical care (control group) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay, hospitalization costs. There was a significant reduction in the median hospitalization costs in the clinical pathway group patients in all five infectious diseases (P<0.05). The clinical pathway group's length of hospital stay for varicella, measles, acute bacillary dysentery and rubella were significantly shorter than the control group (P<0.05). The implementation of clinical pathways in varicella, acute bacillary dysentery, measles, scarlet fever and rubella might contribute to better quality of care and cost-effectiveness.

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Changing doctors' behaviours: an educational program to disseminate a new clinical pathway for the hospital management of hip fractures in elderly patients in the Lazio Region, Italy

Cited by 5 publications

References 16 publications

Models in the balance: evidence‐based medicine versus evidence‐informed individualized care

Models in the balance: evidence‐based medicine versus evidence‐informed individualized care

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella

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