Article type
Year
Abstract
Introduction: Patterns of practice often diverge from recommendations based on evidence. There appear to be a number of factors that influence the adoption of research findings into the actual practice of health care providers. A variety of interventions aimed at improving the performance of health care providers have been investigated.
Objective: To determine the effectiveness of different types of interventions in improving provider performance and health outcomes.
Methods: MEDLINE, EMBASE, CINAHL, ERIC and the Research and Development Resource Base in Continuing Medical Education (RDRB\CME) were searched. Selection criteria: design = random or quasi random allocation of subjects to one or more intervention groups(s); participants = health care providers excluding students; interventions = educational materials, conferences, outreach visits, local opinion leaders, audit and feedback, reminders, marketing and local consensus processes; outcomes = objectively measured provider performance in a health care setting or patient health outcome. The quality of the trials was independently assessed by two reviewers and information regarding methodology, subjects, interventions and outcomes was extracted.
Results: All the interventions that have been investigated have been relatively complex and intensive interventions such as outreach visits and the use of local opinion leaders have at best moderate effects of 20 to 50 percent.
Discussion: There are no magic bullets for improving the quality of health care, but there is a wide range of interventions available that, if used appropriately, can lead to substantial improvements in the application of research and, ultimately the effectiveness and efficiency of health care.
Objective: To determine the effectiveness of different types of interventions in improving provider performance and health outcomes.
Methods: MEDLINE, EMBASE, CINAHL, ERIC and the Research and Development Resource Base in Continuing Medical Education (RDRB\CME) were searched. Selection criteria: design = random or quasi random allocation of subjects to one or more intervention groups(s); participants = health care providers excluding students; interventions = educational materials, conferences, outreach visits, local opinion leaders, audit and feedback, reminders, marketing and local consensus processes; outcomes = objectively measured provider performance in a health care setting or patient health outcome. The quality of the trials was independently assessed by two reviewers and information regarding methodology, subjects, interventions and outcomes was extracted.
Results: All the interventions that have been investigated have been relatively complex and intensive interventions such as outreach visits and the use of local opinion leaders have at best moderate effects of 20 to 50 percent.
Discussion: There are no magic bullets for improving the quality of health care, but there is a wide range of interventions available that, if used appropriately, can lead to substantial improvements in the application of research and, ultimately the effectiveness and efficiency of health care.