Implementation, improved care and back again

Article type
Authors
Delvaux N1, Leng G2, Lockwood C3, Kelley T, Kunnamo I
1Domus Medica, Flemish College General Practitioners
2National Institute for Health and Care Excellence
3Cochrane Nursing Care
Abstract
This session is linked to Plenary 2: BREAKING DOWN THE SILOS: Digital and trustworthy evidence ecosystem

Objectives:
Provide insight into how evidence implemented by targeted clinical decision support (CDS) connects recommended actions to measured outcomes, how selecting effective interventions and monitoring outcomes needs a marriage of traditionally curated evidence and recommendations with big data collected from individuals, and how a closed-loop programme of practice improvement develops professionals’ implementation skills.

Description:

Nicolas Delvaux: Guidelines should be implemented by CDS in a patient-centred approach taking into account the individuals’ characteristics, the context and timing of decision making, and the governance of continuous quality-improvement. The GUIDES checklist on effective CDS, and future directions of integrating evidence implementation and outcome measurement via CDS is discussed.

Thomas Kelley: Measuring what matters to people The presentation introduces the concept of value-based healthcare and how ICHOM is working to translate the theory into practice. The methodology for standard dataset development and two case studies on successful implementation in both developed and low/middle-income country settings are presented. The potential of using patient-reported data is discussed.

Gillian Leng: The whole circle – evidence, recommendations, and ongoing data collection. NICE undertakes a new approach to determining whether evidence-based recommendations for mental ill-health can be delivered more efficiently by digital technologies than by a traditional therapist. The technologies are initially assessed against criteria drawn from traditional randomised-controlled trials, and then introduced for use by patients, using real-world data for ongoing evaluation. Big data are used to predict who will benefit most.

Craig Lockwood: Facilitating practitioner-led implementation at the bedside. Implementation of evidence at the point of care forms part of a closed-loop programme including stakeholder established priority topics informing evidence synthesis and an evidence transfer programme inclusive of active dissemination and systems integration. The JBI clinical fellowship programme’s online system guides participants through the process of improving practice. Case studies will be presented from low/middle-income countries.