title: Improving guideline concordance in multidisciplinary teams: preliminary results of a cluster-randomized trial evaluating the effect of a web-based audit and feedback intervention with outreach visits.
abstract: Despite their widespread use, audit and feedback (A&F) interventions show variable effectiveness on improving professional performance. Based on known facilitators of successful A&F interventions, we developed a web-based A&F intervention with indicator-based performance feedback, benchmark information, action planning and outreach visits. The goal of the intervention was to engage with multidisciplinary teams to overcome barriers to guideline concordance and to improve overall team performance in the field of cardiac rehabilitation (CR). To assess its effectiveness we conducted a cluster-randomized trial in 18 CR clinics (14,847 patients) already working with computerized decision support (CDS). Our preliminary results showed no increase in concordance with guideline recommendations regarding prescription of CR therapies. Future analyses will investigate whether our intervention did improve team performance on other quality indicators.
authors.affiliation: Department of Medical Informatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Mariëtte M
authors.initials: MM
authors.lastname: van Engen-Verheul
authors.affiliation: Department of Medical Informatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Wouter T
authors.initials: WT
authors.lastname: Gude
authors.affiliation: European Renal Best Practice (ERBP) Methods Support Team, University Hospital Ghent, Ghent, Belgium; MRC Health e-Research Centre, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Sabine N
authors.initials: SN
authors.lastname: van der Veer
authors.affiliation: Department of Medical Informatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Cardiology, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: Hareld M C
authors.initials: HM
authors.lastname: Kemps
authors.affiliation: Department of Medical Informatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Monique M W
authors.initials: MM
authors.lastname: Jaspers
authors.affiliation: Department of Medical Informatics, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: de Keizer
authors.affiliation: MRC Health e-Research Centre, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Niels
authors.initials: N
authors.lastname: Peek
mesh_terms: D000072038:Cardiac Rehabilitation; D020000:Decision Support Systems, Clinical; D005246:Feedback; D006801:Humans; D020407:Internet; D010348:Patient Care Team