 |
 |
I’m enjoying and learning from this discussion as always with this list.
As a kidney patient, I’m grateful for guidelines (and consensus statements etc). I use them to ensure I’m getting the best possible care according to
the best possible evidence (even when that evidence is low grade or just best practice), and also to hold providers to account (if necessary).
However, the outcomes, the impact of guidelines on my health are ultimately probably beyond the HCP’s control and influenced by many other factors than
guidelines. For example, medication adherence in BP management or post transplant, or genetic factors, or where someone lives, access to therapies etc.
Guidelines are a component of the process of improving a person’s health outcomes and it might be better to focus energy on improving the guideline
development and implementation processes, rather than agonising whether they are effective or not. More PPI in the development, faster implementation and lay summaries that patients can understand and apply as they self-manage their own care.
Best wishes
Tess
Tess Harris
CEO, PKD Charity
Dir: +44 20 7387 0543
Tweet: @pkdcharity
Facebook: http://www.facebook.com/pkdcharity
The Polycystic Kidney Disease Charity is a registered charity in England and Wales (1160970) and Scotland (SC047730).
Disclaimer
------------
We apply internet security procedures and are not liable for any damage to the recipient caused by malicious software or mutant genes.
From: Evidence based health (EBH) <[log in to unmask]>
On Behalf Of Juan Gérvas
Sent: 22 September 2019 10:29
To: [log in to unmask]
Subject: Re: (External Email) Re: Without evidence of the impact of EBM (health outcomes)
-again, and again
-better "translation" but...what is the impact on patients' health?
Background: More than 50,000 randomized controlled trials and 8000 systematic reviews are anticipated to be published annually in the coming years. This huge volume of published findings makes it challenging
for health care delivery systems to review new evidence, prioritize health care practices that warrant
implementation, and implement best practices.
Objective: The objective of this study was to describe the Kaiser Permanente Southern California E-SCOPE (Evidence Scanning for Clinical, Operational, and Practice Efficiencies) program, a systematic method
to accelerate the implementation of evidence-based practices in clinical care settings.
Methods: E-SCOPE uses a strategic evidence search algorithm to conduct proactive literature searches to identify high-quality studies of interventions that yield improved health outcomes, quality and/or
efficiency of care delivery, or cost savings. Each quarterly search yields 500–1000 abstracts; about 5%–10% of studies are selected each quarter for consideration for
implementation. These studies are presented to clinical and operational leaders and other stakeholders to make the final determination regarding the
implementation of the practice; E-SCOPE staff work closely with stakeholders to develop an
implementation plan, identify practice owners, and ensure sustainability.
Results: The time from study publication to
implementation using the E-SCOPE process ranges from 4 to 36 months, with an average of
∼16 months. Four examples of E-SCOPE
implementation efforts, including new deployment, scale-up/spread, deimplementation, and operational efforts, are described.
Conclusion: A single, centralized program for the proactive identification of the most up-to-date, evidence-based best practices and facilitated
implementation can efficiently and effectively promote continuous learning and
implementation in a learning health care system.
-un saludo juan gérvas @JuanGrvas
El mié., 11 sept. 2019 a las 11:48, Douglas Badenoch (<[log in to unmask]>) escribió: