Implementing Evidence In Practise

Question 1

What is a source for identifying a population’s health priorities?

Answer 1

James Lind Alliance, a non profit which facilitates the collaboration between researchers, patients and carers for identifiying unanswered questions of the most relevance to the health of the population.

Question 2

What is the research cycle?

Answer 2

Identifying a clinical problem
Basic research in the laboratory
Applied research
Clinical care

Question 3

What is appplied research?

Answer 3

Research design is based on the hypothesis/question that is being posed.

Question 4

What is the research design for interventions?

Answer 4

Comparative studies e.g RCTs.

Question 5

What is the research design for prognosis?

Answer 5

Cohort studies, using relative risk ratio.

Question 6

What is the research design for treatment value?

Answer 6

Cost-effectiveness study such as:
Cost effectiveness analysis
Cost minimisation
Utility Value

Question 7

What is the research design for diagnosis?

Answer 7

Comparative study e.g RCTs.

Question 8

What is a source for up-to-date information for decision making?

Answer 8

Cochrane library which provides reliable information of medical findings for comparison of options.
NICE provides guidelines for medical practise
BMJ
NIH

Question 9

What is a limitation to implementing new evidence based methods in healthcare?

Answer 9

Barreck’s categories state that the barrier to implantation is:
Perception of the method
Characteristics of the people carrying it out
Contextual factors

Question 10

How does perception influence implementation of new practise?

Answer 10

Based on the perceived benefit of the unknown method to the possible risks.
Complexity/Simplicity of the innovation
There is a greater likelihood if there is more knowledge of the consequences, called reduction uncertainty.

Question 11

How do contextual factors affect implementation of a new practise?

Answer 11

Based on:
Incentive
Resources
Leadership styles and communication with management

Question 12

How do characteristics of the adopters affect the implementation of a new practise?

Answer 12

Current knowledge and abilities
Attitudes and beliefs
Knowledge

Question 13

What are the barriers in prescribing the most clinically effective antibiotics?

Answer 13

Medical hierarchy, based on the prescribing norms of the team set by senior colleagues
The opinions of senior colleagues towards current guidelines
Patient expectation
Fear of criticism and appearing competent
Individual responsibility and reputation in the team

Question 14

What are policies for successfully implementing evidence-based practise?

Answer 14

Quality improvement
National CQUINs
Quality and Outcomes Framework

Question 15

What are the aims of quality improvement?

Answer 15

Provides knowledge and interactive methods to implement change and view it as normal.

Question 16

What are methods for quality improvement?

Answer 16

Educational meetings and outreach visits from local opinion leaders
Inter-institutional communication
Networking recognition for high quality practises
Benchmarking cycles and audits to identify variation in practise
Financial incentives

Question 17

What is a system in general practise for encouraging evidence-based medicine?

Answer 17

Quality and Outcomes Framework, which is a governmental commissioner by the NIH that provides financial incentive to GP’s for rewarding ‘excellence’ by comparing care quality and delivery compared to previous years.

However, there are issues due to neglect of unincentivised areas of care.

Question 18

What is the CQUIN?

Answer 18

Commissioning for care quality and innovation, which determines that a proportion of a healthcare provider’s income is dependent on the improvements they make in quality of services and new improved patterns of care.