2.50
Hdl Handle:
http://hdl.handle.net/10755/155348
Type:
Presentation
Title:
Implementing Change in Primary Care
Abstract:
Implementing Change in Primary Care
Conference Sponsor:Sigma Theta Tau International
Conference Year:2006
Author:Nemeth, Lynne S., PhD, RN
P.I. Institution Name:Medical University of South Carolina
Title:Research Assistant Professor
Context: Major gaps exist related to the availability of clinical evidence, best practices, measures and performance in health care. Evidence-based guidelines and electronic medical record (EMR) tools provide tremendous potential for improving the quality of care. The impact of these tools is highly variable, related to differences in their implementation and unique characteristics of the practice setting. Objective: The purpose of this research was to explore the process of change used to implement clinical guidelines in primary care practices using electronic medical records. The goal was to generate a conceptual framework for implementing change in primary care practices. Design: Mixed methods qualitative study developed within a practice based primary care research network. Setting: Eight community-based primary care practices in seven states were intervention sites in the Practice Partner Research Network -Translating Research into Practice (PPRNet-TRIP II) pragmatic clinical trial, "Primary and Secondary Prevention of Cardiovascular Disease and Stroke". Participants: A maximum variation, purposive sample of practice members from each of the eight intervention sites were selected for in-depth interviews. Sample included physicians, midlevel providers, nurses, other clinical staff, office staff and managers. Instrument: Field notes recording observations from periodic site visits per site provided context for in-depth interviews. Interviews were adapted from the Microsystems in Healthcare study. Evaluation data from the TRIP-II study and organizational cultural characteristics measured through the Practice Staff Questionnaire provided additional descriptive data to enrich the case studies.  Results: Case descriptions illustrated variations in the change process and practice based ratings regarding perceptions of organizational culture. The conceptual framework "How to Lead Change for PPRNet-TRIP" illustrates the characteristics of the process of change. Conclusions: Practices that develop clear goals, involve and develop their teams, refine systems and use performance data are successful in improvement and change.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementing Change in Primary Careen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155348-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementing Change in Primary Care</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">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Nemeth, Lynne S., PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Medical University of South Carolina</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">nemethl@musc.edu</td></tr><tr><td colspan="2" class="item-abstract">Context: Major gaps exist related to the availability of clinical evidence, best practices, measures and performance in health care. Evidence-based guidelines and electronic medical record (EMR) tools provide tremendous potential for improving the quality of care. The impact of these tools is highly variable, related to differences in their implementation and unique characteristics of the practice setting. Objective: The purpose of this research was to explore the process of change used to implement clinical guidelines in primary care practices using electronic medical records. The goal was to generate a conceptual framework for implementing change in primary care practices. Design: Mixed methods qualitative study developed within a practice based primary care research network. Setting: Eight community-based primary care practices in seven states were intervention sites in the Practice Partner Research Network -Translating Research into Practice (PPRNet-TRIP II) pragmatic clinical trial, &quot;Primary and Secondary Prevention of Cardiovascular Disease and Stroke&quot;. Participants: A maximum variation, purposive sample of practice members from each of the eight intervention sites were selected for in-depth interviews. Sample included physicians, midlevel providers, nurses, other clinical staff, office staff and managers. Instrument: Field notes recording observations from periodic site visits per site provided context for in-depth interviews. Interviews were adapted from the Microsystems in Healthcare study. Evaluation data from the TRIP-II study and organizational cultural characteristics measured through the Practice Staff Questionnaire provided additional descriptive data to enrich the case studies. &nbsp;Results: Case descriptions illustrated variations in the change process and practice based ratings regarding perceptions of organizational culture. The conceptual framework &quot;How to Lead Change for PPRNet-TRIP&quot; illustrates the characteristics of the process of change. Conclusions: Practices that develop clear goals, involve and develop their teams, refine systems and use performance data are successful in improvement and change.</td></tr></table>en_GB
dc.date.available2011-10-26T13:45:39Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T13:45:39Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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