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Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol.

Abstract：

BACKGROUND:Canada is among the most prosperous nations in the world, yet the health and wellness outcomes of Canadian children are surprisingly poor. There is some evidence to suggest that these poor health outcomes are partly due to clinical practice variation, which can stem from failure to apply the best available research evidence in clinical practice, otherwise known as knowledge translation (KT). Surprisingly, clinical practice variation, even for common acute paediatric conditions, is pervasive. Clinical practice variation results in unnecessary medical treatments, increased suffering, and increased healthcare costs. This study focuses on improving health outcomes for common paediatric acute health concerns by evaluating strategies that improve KT and reduce clinical practice variation. DESIGN/METHODS:Using a multiple case study design, qualitative and quantitative data will be collected from four emergency departments in western Canada. Data sources will include: pre- and post-implementation focus group data from multidisciplinary healthcare professionals; individual interviews with the local champions, KT intervention providers, and unit/site leaders/managers; Alberta Context Tool (ACT) survey data; and aggregated patient outcome data. Qualitative and quantitative data will be systematically triangulated, and matrices will be built to do cross-case comparison. Explanations will be built about the success or lack of success of the clinical practice guidelines (CPG) and clinical pathways (CPs) uptake based upon the cross-case comparisons. SIGNIFICANCE:This study will generate new knowledge about the potential causal mechanisms and factors which shape implementation. Future studies will track the impact of the CPG/CPs implementation on children's health outcome, and healthcare costs.

journal_name

Implement Sci

journal_title

Implementation science : IS

authors

Scott SD,Grimshaw J,Klassen TP,Nettel-Aguirre A,Johnson DW

doi

10.1186/1748-5908-6-133

subject

Has Abstract

pub_date

2011-12-28 00:00:00

pages

133

issn

1748-5908

pii

1748-5908-6-133

journal_volume

pub_type

杂志文章,多中心研究

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Understanding implementation processes of clinical pathways and clinical practice guidelines in pediatric contexts: a study protocol.