Model To Improve the Delivery of Clinical Preventive Services Among Health Plans

2.50
Hdl Handle:
http://hdl.handle.net/10755/154705
Type:
Presentation
Title:
Model To Improve the Delivery of Clinical Preventive Services Among Health Plans
Abstract:
Model To Improve the Delivery of Clinical Preventive Services Among Health Plans
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Griffith, Hurdis, PhD
P.I. Institution Name:Rutgers, The State University of New Jersey
Title:Dean and Professor
Objective: The delivery rates of specific Clinical Preventive Services (CPS) in NJ’s Health Plans (HP) are below state and national goals. Lack of a consistent approach to the delivery of clinical preventive practices may be a barrier to the implementation of these services. Clinicians contract with a number of HPs and are confronted with many sets of conflicting guidelines for preventive care. Therefore, the objective of this study is to bring NJ HPs to agreement on a consistent set of CPS guidelines (Phase I) and guideline implementation tools (Phase II). These activities are part of a larger developmental study with the overall objective to develop a program to increase delivery of CPS throughout the State. Design: Phase I and II are quasi-experimental pretest-posttest designs. Sample, Population, Setting, Years: In Phase I and Phase II, the sample consists of nine Medical Directors of the largest HPs in NJ; HPs that cover 2,293,491 of the 2,358,474 NJ residents enrolled in HMOs. This sample was chosen to represent all HP Medical Directors in NJ. These activities began last June and were completed in February. Intervention and Outcome Variable(s): The expected outcomes of Phase I and Phase II are the development of consensus among the Medical Directors regarding CPS guidelines (Phase I) and implementation tools (Phase II) to be used by contracted HP clinicians. Interventions included consultation of experts presented at project meetings and feedback of group ratings (group modal, mean and median responses) from initial surveys. Methods: The Delphi Method was used to reach consensus by the Medical Directors on the CPS guidelines (Phase I) and implementation tools (Phase II). The first survey collected baseline information on each HP’s level of agreement or disagreement with the CPS guidelines. A scientific expert discussed these guidelines and a second survey, providing group’s ratings to the listed CPS guidelines, was given. Delphi Rounds addressing the priority level of each positive recommendation was facilitated. A survey to collect information on guideline implementation tools was then implemented. Findings: Data from the first Delphi Round demonstrated 14 areas of disagreement (<85% agreement) among HPs; seven areas of disagreement (<85% agreement) in the second Delphi Round. Consensus on these areas was reached among HPs at a Coalition Meeting that followed. 18 CPS receiving the highest rankings were selected for inclusion on a laminated sheet for clinician reference. The Medical Directors identified the implementation tools they believed would be most helpful in clinician practice. Conclusions: The interventions in this study provided the means to bring HP Medical Directors to consensus on CPS guidelines and tools. These activities provide the groundwork necessary to work with clinicians directly responsible for implementing preventive services. Future work with contracted HP clinicians will be done through focus groups. Implications: Conflicting and confusing guidelines are detrimental to the delivery of preventive care and create a major system barrier against the improvement of these services. This study uses a systematic approach to reach consensus among HP Medical Directors on CPS guidelines and implementation tools. This approach will provide a template for HPs nationwide to come to consensus on guidelines and implementation tools that support clinicians in the delivery of CPS. The momentum is increasing in support of evidence-based practice that will improve the quality of patient care and decrease the morbidity and mortality of preventable diseases. Nurses need time and organizational support to access and synthesize the best evidence for making changes in practice. Great opportunity exists to work collaboratively with HPs in promoting the delivery of these preventive services.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleModel To Improve the Delivery of Clinical Preventive Services Among Health Plansen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154705-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Model To Improve the Delivery of Clinical Preventive Services Among Health Plans</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Griffith, Hurdis, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Rutgers, The State University of New Jersey</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Dean and Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">griffith@nightingale.rutgers.e</td></tr><tr><td colspan="2" class="item-abstract">Objective: The delivery rates of specific Clinical Preventive Services (CPS) in NJ&rsquo;s Health Plans (HP) are below state and national goals. Lack of a consistent approach to the delivery of clinical preventive practices may be a barrier to the implementation of these services. Clinicians contract with a number of HPs and are confronted with many sets of conflicting guidelines for preventive care. Therefore, the objective of this study is to bring NJ HPs to agreement on a consistent set of CPS guidelines (Phase I) and guideline implementation tools (Phase II). These activities are part of a larger developmental study with the overall objective to develop a program to increase delivery of CPS throughout the State. Design: Phase I and II are quasi-experimental pretest-posttest designs. Sample, Population, Setting, Years: In Phase I and Phase II, the sample consists of nine Medical Directors of the largest HPs in NJ; HPs that cover 2,293,491 of the 2,358,474 NJ residents enrolled in HMOs. This sample was chosen to represent all HP Medical Directors in NJ. These activities began last June and were completed in February. Intervention and Outcome Variable(s): The expected outcomes of Phase I and Phase II are the development of consensus among the Medical Directors regarding CPS guidelines (Phase I) and implementation tools (Phase II) to be used by contracted HP clinicians. Interventions included consultation of experts presented at project meetings and feedback of group ratings (group modal, mean and median responses) from initial surveys. Methods: The Delphi Method was used to reach consensus by the Medical Directors on the CPS guidelines (Phase I) and implementation tools (Phase II). The first survey collected baseline information on each HP&rsquo;s level of agreement or disagreement with the CPS guidelines. A scientific expert discussed these guidelines and a second survey, providing group&rsquo;s ratings to the listed CPS guidelines, was given. Delphi Rounds addressing the priority level of each positive recommendation was facilitated. A survey to collect information on guideline implementation tools was then implemented. Findings: Data from the first Delphi Round demonstrated 14 areas of disagreement (&lt;85% agreement) among HPs; seven areas of disagreement (&lt;85% agreement) in the second Delphi Round. Consensus on these areas was reached among HPs at a Coalition Meeting that followed. 18 CPS receiving the highest rankings were selected for inclusion on a laminated sheet for clinician reference. The Medical Directors identified the implementation tools they believed would be most helpful in clinician practice. Conclusions: The interventions in this study provided the means to bring HP Medical Directors to consensus on CPS guidelines and tools. These activities provide the groundwork necessary to work with clinicians directly responsible for implementing preventive services. Future work with contracted HP clinicians will be done through focus groups. Implications: Conflicting and confusing guidelines are detrimental to the delivery of preventive care and create a major system barrier against the improvement of these services. This study uses a systematic approach to reach consensus among HP Medical Directors on CPS guidelines and implementation tools. This approach will provide a template for HPs nationwide to come to consensus on guidelines and implementation tools that support clinicians in the delivery of CPS. The momentum is increasing in support of evidence-based practice that will improve the quality of patient care and decrease the morbidity and mortality of preventable diseases. Nurses need time and organizational support to access and synthesize the best evidence for making changes in practice. Great opportunity exists to work collaboratively with HPs in promoting the delivery of these preventive services. </td></tr></table>en_GB
dc.date.available2011-10-26T13:12:43Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T13:12:43Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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