Implementation of the asthma practice guideline in the Army Medical Department : evaluation of process and effects / Donna O. Farley ... [et al.].

Format:

Book

Contributor:

Arroyo Center.

Center for Military Health Policy Research.

Farley, Donna.

Language:

English

Subjects (All):

Asthma--Treatment--United States.

Asthma.

United States. Army--Medical care.

United States.

Physical Description:

1 online resource (xxxiv, 176 pages) : illustrations

Edition:

1st ed.

Place of Publication:

Santa Monica, CA : Rand, c2005.

Language Note:

English

Summary:

In partnership with the Army Medical Department (AMEDD), RAND researchers worked to implement clinical practice guidelines in treatment of three common ailments (asthma, diabetes, and low back pain). This report is an evaluation of the asthma practice guideline demonstration. It documents the extent to which intended actions were implemented, assesses short-term effects on clinical practices, and measures the quality and limitations of available data for monitoring practice improvements and clinical outcomes. The authors found that, although the implementation scored some notable successes, resource limitations and organizational barriers curbed overall progress. They conclude that allowing for flexibility, monitoring the facilities consistently, and training providers thoroughly are the keys to implementing the practice guidelines throughout AMEDD. The also concluded that patient education was an area in need of improvement

Contents:

Preface; Contents; Figures; Tables; Summary; Acknowledgments; Abbreviations; CHAPTER ONE- Introduction; Overview of the Military Health System; The DoD/VA Guideline Adaptation Process; The AMEDD-RAND Guideline Implementation Project; Overview of the Asthma Practice Guideline; A Systems Approach to Implementation; The AMEDD Guideline Implementation Process; The Demonstration Sites; The RAND Evaluation; Organization of This Report; CHAPTER TWO- Methods and Data; Process Evaluation Methods; Outcome Evaluation; Estimating the Costs of Care

CHAPTER THREE- Asthma Populations and Practices at the Baseline The Asthma Population Served by Army MTFs; Baseline Performance on Asthma Care Measures at the Study MTFs; Summary; CHAPTER FOUR- The Guideline Implementation Process; MEDCOM Support; Structure and Support at the MTFs; Implementation Activities and Progress; Lessons Learned; CHAPTER FIVE- Effects of Guideline Implementation; Provider Knowledge and Acceptance of the Guideline; Reported Changes in Clinical Practices; Analysis of Effects on Service Delivery; Estimated Costs of Care; Summary

CHAPTER SIX- Synthesis of Findings from the Demonstration Findings on the Implementation Process; Effects of Implementing Practice Improvements; Data Issues; Recommendations; APPENDIX A- Hypotheses for Effects of Improved Asthma Care Practices; APPENDIX B- Evaluation Methodology; APPENDIX C- Modules of the Climate Survey; APPENDIX D- Physician Questionnaire; APPENDIX E- Analyses of Asthma Metrics; Bibliography

Notes:

Description based upon print version of record.

Includes bibliographical references (p. 173-176).

OCLC:

781422377