Enhancing Physician Adoption of Practice Guidelines

Abstract

A case is made for the small-group consensus process as an effective utilization-focused dissemination method. Interventions based on group dynamics and sensitive to local practice contexts can be useful in facilitating adoption of guidelines by physicians in group practices.

An Intervention Integrated into Daily Clinical Practice Reduces the Incidence of Delirium During Hospitalization in Elderly Patients

“…As shown by other authors, audits and feedback measures can improve medical practice. 32,33 Actions such as avoiding medication during sleep time, avoiding physical restraints, and encouraging the use of glasses and hearing aids were quick and easy to implement and did not require extra staff. Other actions, such as daily mobilization, are more complex and time consuming.…”

A Multifactorial Intervention to Reduce Prevalence of Delirium and Shorten Hospital Length of Stay

“…The multifactorial intervention was associated with significant changes in pharmacological treatment of older adults. Education interventions without audit and feedback do not usually produce significant change in physician practices 18–21 . For this reason, nurses on the AGU were trained to provide immediate feedback on physician practice.…”

“…Education interventions without audit and feedback do not usually produce significant change in physician practices. [18][19][20][21] For this reason, nurses on the AGU were trained to provide immediate feedback on physician practice. Without their participation in a strong, authorized role, it is unlikely that medication use would have changed significantly.…”

Interrater Agreement Among Psychiatrists in Psychiatric Emergency Assessments

“…Practice guidelines are rapidly being developed in psychiatry and general medicine and are heralded as facilitating more consistent, effective, and efficient medical care (6,33); however, compliance by physicians is low (34). Research is beginning to focus on techniques to enhance adoption of guidelines (35), and these efforts should continue and include psychiatry.…”