Organizational and provider characteristics fostering smoking cessation practice guideline adherence: an empirical look.
We examined the relationship between physician adherence with a smoking cessation guideline and organizational structures, policies, leadership support, and physician knowledge and attitudes. A random sample of 844 physicians practicing in 127 VHA hospitals was surveyed. Survey results were aggregated to the hospital level and linked with data on organizational characteristics from the 1998 annual survey of hospitals by the American Hospital Association. Significant predictors of adherence included organizational policies related to nicotine replacement prescriptions, the timing and effectiveness of guideline implementation, physicians' knowledge of VHA clinical guidelines generally, and physicians' beliefs about the receptiveness of patients to smoking cessation.
Vaughn
Thomas E
TE
Department of Health Management and Policy, University of Iowa College of Public Health, USA.
Ward
Marcia M
MM
Doebbeling
Bradley N
BN
Uden-Holman
Tanya
T
Clarke
William T
WT
Woolson
Robert F
RF
D000573:American Hospital Association; D001291:Attitude of Health Personnel; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006787:Hospitals, Veterans / Q000592:standards; D006801:Humans; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011897:Random Allocation; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014481:United States