Applying evidence into routine clinical care at a unit level: the exemplar of renal anaemia management.
Variability in implementing research evidence into clinical practice is widespread, including in the management of patients with kidney disease. There are numerous well-known barriers and facilitators to evidence implementation identified in other clinical settings and a few chronic kidney disease studies. The necessary changes to health systems that support evidence implementation take time to design, apply and to have a measurable effect. Measurement against an agreed standard is fundamental to this process. We use the example of renal anaemia management across a dialysis unit to illustrate an approach to these issues.
Gallagher
Martin P
MP
The George Institute for International Health, Renal Division, PO Box 201, Missenden Road, Camperdown, NSW 2050, Australia. mgallagher@george.org.au
Cass
Alan
A
Craig
Jonathan C
JC
D000740:Anemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D019091:Critical Pathways / Q000458:organization & administration; D003695:Delivery of Health Care / Q000458:organization & administration; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000150:complications / Q000628:therapy*; D009937:Organizational Objectives; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D016896:Treatment Outcome
D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins