Clinician education: a key to implementing asthma guidelines?

Griffiths, Chris; Feder, Gene

doi:10.1136/qshc.8.2.73

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…(Davis, Thomson, Oxman, et al 1995;Greco and Eisenberg 1993). Educational strategies may be more powerful if used in conjunction with other interventions (Griffiths and Feder 1999). This is because individual approaches fail to recognize that medicine is largely practiced as part of a group or team embedded within a complex organizational structure.…”

Section: Multilevel Approach To Changementioning

confidence: 99%

Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change

2001

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Fueled by public incidents and growing evidence of deficiencies in care, concern over the quality and outcomes of care has increased in both the United Kingdom and the United States. Both countries have launched a number of initiatives to deal with these issues. These initiatives are unlikely to achieve their objectives without explicit consideration of the multilevel approach to change that includes the individual, group/team, organization, and larger environment/system level. Attention must be given to issues of leadership, culture, team development, and information technology at all levels. A number of contingent factors influence these efforts in both countries, which must each balance a number of tradeoffs between centralization and decentralization in efforts to sustain the impetus for quality improvement over time. The multilevel change framework and associated properties provide a framework for assessing progress along the journey.

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Section: Multilevel Approach To Changementioning

confidence: 99%

Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change

2001

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Greenwich asthma study

Feder

2000

BMJ

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Ideal body weight is not realistic goal for lifestyle intervention Editor-Ramsay et al have produced a clear and authoritative document with their recent guidelines for the treatment of hypertension. 1 The section on lifestyle modification, however, includes the statement that weight loss to achieve an ideal body weight will lower blood pressure. Although this is undoubtedly true, it undermines most recent guidelines that recognise the practical near impossibility of achieving ideal body weight in most obese subjects 2-4 and evidence that suggests that more modest (and achievable) reductions in weight of 5-10% of body weight can be effective at lowering systolic and diastolic blood pressure in the range of 4-7 and 3-6 mm Hg respectively. 5 It should be made explicit in the guidelines that this degree of weight loss is likely to be beneficial in reducing cardiovascular risk, rather than perpetuating the myth that "ideal" body weight is a realistic goal of lifestyle modification in overweight and obese subjects.

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Clinician education: a key to implementing asthma guidelines?

Cited by 2 publications

References 14 publications

Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change

Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change

Greenwich asthma study

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