Primary Care, Virginia Mason Medical Center, Seattle, Washington, USA.
Center for Health Care Improvement Science, Virginia Mason Franciscan Health, Tacoma, Washington, USA
BMJ Open Qual. 2022 Dec;11(4). doi: 10.1136/bmjoq-2022-002032.
Evidence-based medical practice is often slow to diffuse into widespread clinical practice. To accelerate translation of updated best practices into clinical care, we developed a quality improvement intervention called the 'Clinical Spotlight'. This programme was based on a knowledge translation model of four steps: education on evidence-based practices, using Lean for incorporation into patient care flow, support of implementation and sustainability, and measurement of outcomes. Using the Clinical Spotlight intervention for addressing the care of patients with type 2 diabetes was associated with appropriate increases in the use of newer classes of glycaemic control medications. We demonstrate statistically significant increases in the use of promoted glycaemic control agents (sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist classes of drugs) at the time of intervention. We conclude that translation of evidence-based practices into clinical care can be enhanced through an educational intervention linked to Lean process improvement and with supported implementation. We are currently expanding our programme to additional clinical areas in primary care.
循证医学实践往往难以迅速普及到临床实践中。为了加速将最新最佳实践转化为临床护理,我们开发了一种名为“临床聚焦”的质量改进干预措施。该计划基于知识转化的四个步骤:基于证据的实践教育,使用精益方法将其融入患者护理流程,实施和可持续性支持,以及结果衡量。使用临床聚焦干预措施来治疗 2 型糖尿病患者与新型血糖控制药物的合理使用增加有关。我们在干预时观察到所推广的血糖控制药物(钠-葡萄糖协同转运蛋白 2 抑制剂和胰高血糖素样肽-1 受体激动剂类药物)的使用显著增加。我们的结论是,通过与精益流程改进相关联的教育干预措施以及实施支持,可以提高将循证实践转化为临床护理的效果。我们目前正在将我们的计划扩展到初级保健的其他临床领域。