title: The logic behind a multimethod intervention to improve adherence to clinical practice guidelines in a nationwide network of primary care practices.
abstract: The gap between evidence-based guidelines for clinical care and their application in medical settings is well established and widely discussed. Effective interventions are needed to help health care providers reduce this gap. Whereas the development of clinical practice guidelines from biomedical and clinical research is an example of Type 1 translation, Type 2 translation involves successful implementation of guidelines in clinical practice. This article describes a multimethod intervention that is part of a Type 2 translation project aimed at increasing adherence to clinical practice guidelines in a nationwide network of primary care practices that use a common electronic medical record (EMR). Practice performance reports, site visits, and network meetings are intervention methods designed to stimulate improvement in practices by addressing personal and organizational factors. Theories and evidence supporting these interventions are described and could prove useful to others trying to translate medical research into practice. Additional theory development is needed to support translation in medical offices.
authors.affiliation: University of Southern California, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Feifer
authors.forename: Steven M
authors.initials: SM
authors.lastname: Ornstein
authors.forename: Ruth G
authors.initials: RG
authors.lastname: Jenkins
authors.forename: Andrea
authors.initials: A
authors.lastname: Wessell
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Corley
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Nemeth
authors.forename: Loraine
authors.initials: L
authors.lastname: Roylance
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nietert
authors.forename: Heather
authors.initials: H
authors.lastname: Liszka
mesh_terms: D035843:Biomedical Research / Q000458:organization & administration; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000458:organization & administration*; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D008485:Medical Audit; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000458:organization & administration