McKeirnan Kimberly, Colorafi Karen, Sun Zuan, Daratha Kristopher, Potyk Darryl, McCarthy John
College of Pharmacy and Pharmaceutical Sciences, Washington State University, Pullman, WA 99202, USA.
School of Nursing and Human Physiology, Gonzaga University, Spokane, WA 99202, USA.
Vaccines (Basel). 2021 Mar 31;9(4):317. doi: 10.3390/vaccines9040317.
Academic detailing is an educational approach involving provision of evidence-based information by healthcare providers for healthcare providers with the goal of improving clinical decision-making. An interprofessional academic detailing initiative was developed to encourage rural providers to utilize guidelines when deciding which patients to vaccinate against pneumonia. This study utilized a quasi-experimental, single-group, pre-post observational design with physicians, nurses, and staff at two rural medical clinics. The 12-month academic detailing intervention included a needs assessment, workflow assessment of practice-based health information technology, vaccination training for providers and staff, and creation of exam-room posters encouraging patients to discuss vaccination with their provider. Six visits were made to deliver education, discuss needs, select priorities, and develop action plans from recommendations. Data were collected from each site for three years prior to the intervention year and for one year following the intervention. The annual rate of patients vaccinated increased during the five-year study. The cumulative proportion of the sample population that received vaccination also increased over time. Interprofessional academic detailing was well received and increased pneumococcal vaccination rates among rural-dwelling older adults. Given the alarming disparities in health outcomes for rural patients, educational outreach is needed to improve healthcare access and outcomes.
学术推广是一种教育方法，由医疗保健提供者向医疗保健提供者提供循证信息，目的是改善临床决策。开展了一项跨专业学术推广倡议，以鼓励农村医疗服务提供者在决定为哪些患者接种肺炎疫苗时遵循指南。本研究采用了准实验、单组、前后观察设计，研究对象为两家农村医疗诊所的医生、护士和工作人员。为期12个月的学术推广干预包括需求评估、基于实践的健康信息技术工作流程评估、为医疗服务提供者和工作人员提供疫苗接种培训，以及制作诊室海报，鼓励患者与医疗服务提供者讨论疫苗接种问题。进行了六次访问，以提供教育、讨论需求、确定优先事项，并根据建议制定行动计划。在干预前三年和干预后一年从每个地点收集数据。在为期五年的研究中，每年接种疫苗的患者比例有所增加。接种疫苗的样本人群累积比例也随时间增加。跨专业学术推广受到好评，并提高了农村老年居民的肺炎球菌疫苗接种率。鉴于农村患者健康结果存在惊人差异，需要开展教育推广活动，以改善医疗服务的可及性和结果。
