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Putting outcomes research into practice CURRENT ISSUES The translation of outcomes research into clinical practice is an 'important activity for health care systems striving to measure and report quality of care activities', says Professor Nelda Johnson from the University of Illinois at Chicago, US. Professor Johnson notes that there is a considerable gap between the results of research evidence and the use of treatments in clinical practice. She identifies the following steps for translating outcomes research into practice. The way to implementation Professor Johnson suggests that the first step is to identify an area where there is a gap between research and practice, and where care requires improvement. The next step is to conduct a comprehensive search for research evidence. High-quality information 'must serve as the foundation for translating research into practice', notes Professor Johnson. This information ..... aarl'"' .. ,.,. he. .fn.-r tho cnot"lf1, .... J.J.'-'........._._., I.V l...IV '-'' C..UU"-41l.'-'U. .I.VJ. "-LJ.""" ._,.t"""..,...&.&..&w .t"'"' __ .,..,. __ ._. .... .,. ......... 0. Once the research evidence has been obtained and a decision for implementation has been made, a number of steps are recommended to promote implementation: specification of the desired changes in clear, measurable terms involvement of key players identification of any barriers to change allocation of resources and personnel for the implementation process selection of dissemination methods. Dissemination strategies that have consistently been shown to be effective are: educational outreach visits; manual or computerised reminders; interactive educational workshops; and multifaceted interven- tions such as audit and feedback, reminders and local consensus process. Don 'l forget about monitoring After implementation, the effectiveness of the intervention programme needs to be assessed. A performance-based measurement, such as compliance with evidence-based guidelines, is a way of monitoring the results, says Professor Johnson. She points out that compliance with evidence- based research never reaches 100%; target compliance levels need to take into account the percentage of patients not eligible for therapy. Professor Johnson notes that several healthcare organisations now have outcomes reporting systems in place to provide feedback. These systems will be 'quite beneficial', once they are automated and provide useful information in a timely fashion, she concludes. Johnson N. Translating and implementing outcomes research into clinical practice. Formulary 34: 251-256. Mar 1999 ""'"''•" 1173-550$199/0209-0005/$01.00° Adla International Limited 1999. All rlghta reaerved 5 PhannacoEconomics & Outr:omes News 24 Apr 1999 No. 209

Putting outcomes research into practice

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Putting outcomes research into practice

CURRENT ISSUES

The translation of outcomes research into clinical practice is an 'important activity for health care systems striving to measure and report quality of care activities', says Professor Nelda Johnson from the University of Illinois at Chicago, US.

Professor Johnson notes that there is a considerable gap between the results of research evidence and the use of treatments in clinical practice. She identifies the following steps for translating outcomes research into practice.

The way to implementation Professor Johnson suggests that the first step is to

identify an area where there is a gap between research and practice, and where care requires improvement.

The next step is to conduct a comprehensive search for research evidence. High-quality information 'must serve as the foundation for translating research into practice', notes Professor Johnson. This information ..... aarl'"' .. ,.,. he. .cur~ln<'lh:~rl .fn.-r tho cnot"lf1,.... nr~l""tlf"P ~Ptt;no J.J.'-'........._._., I.V l...IV '-'' C..UU"-41l.'-'U. .I.VJ. "-LJ.""" ._,.t"""..,...&.&..&w .t"'"' __ .,..,. __ ._. .... .,. ......... 0.

Once the research evidence has been obtained and a decision for implementation has been made, a number of steps are recommended to promote implementation: • specification of the desired changes in clear, measurable terms • involvement of key players • identification of any barriers to change • allocation of resources and personnel for the implementation

process • selection of dissemination methods.

Dissemination strategies that have consistently been shown to be effective are: educational outreach visits; manual or computerised reminders; interactive educational workshops; and multifaceted interven­tions such as audit and feedback, reminders and local consensus process.

Don 'l forget about monitoring After implementation, the effectiveness of the

intervention programme needs to be assessed. A performance-based measurement, such as compliance with evidence-based guidelines, is a way of monitoring the results, says Professor Johnson.

She points out that compliance with evidence­based research never reaches 100%; target compliance levels need to take into account the percentage of patients not eligible for therapy.

Professor Johnson notes that several healthcare organisations now have outcomes reporting systems in place to provide feedback. These systems will be 'quite beneficial', once they are automated and provide useful information in a timely fashion, she concludes.

Johnson N. Translating and implementing outcomes research into clinical practice. Formulary 34: 251-256. Mar 1999 ""'"''•"

1173-550$199/0209-0005/$01.00° Adla International Limited 1999. All rlghta reaerved

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PhannacoEconomics & Outr:omes News 24 Apr 1999 No. 209