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Facilitating the Implementation of EPC Reports in Learning Health Systems Engaged in Quality Initiatives: an EPC Pilot Project on ADHD
Methods Research Report
Investigators: Allison S. Morrow, B.A., Mary Butler, Ph.D., M.B.A., and M. Hassan Murad, M.D., M.P.H.
Structured Abstract
Background:
Evidence synthesis reports prepared by the Evidence-based Practice (EPC) program are critical to providing evidence for clinical practice and guideline development. However, from the perspective of a health system focused on quality improvement (QI), such large evidence reports with wide scope are difficult to implement within a QI initiative.
Methods:
We consulted with two health systems to identify a published EPC report on a topic of interest to future quality initiatives. After identifying the target report on attention deficit hyperactivity disorder (ADHD), we gathered feedback from the health system to determine what information on ADHD treatments is the most relevant to their quality initiatives and the most useful way to deliver this information. We then developed a prototype product derived from the original EPC report, supplemented by newly abstracted contextual material from the included studies as well as outside resources. We presented the tool to representatives from two health systems and two parents of children with ADHD to obtain feedback and modify/enhance the product in an iterative fashion. A designer assisted in improving the usability, readability, and presentation of the product.
Results:
Stakeholders requested practical information to support applying the findings of the evidence report, including a parent and family education guide, resources to recommend for parents, current best practices from leading practitioners, and advise on medication management. We developed a parent and family education guide that included example curricula based on three randomized trials identified by the report. Cost information was explicitly requested but was difficult to obtain. Health system stakeholders and parents of children valued the guide, suggesting possible new products for the EPC program. The lessons learned from this pilot project include; (1) Post publication processing of EPC reports is needed to cater to a health system QI needs, (2) A product with narrow focus is critical for QI initiatives, (3) Engagement of stakeholders is essential, (4) Data need to be re-extracted from included studies, and (5) Additional sources of data from outside the report are commonly required.
Conclusion:
An implementation tool derived from an EPC report and developed with stakeholder feedback may facilitate implementation of evidence in a health system engaged in a quality improvement initiative.
Contents
Suggested citation:
Suggested citation: Morrow AS, Butler M, Murad MH. Facilitating the Implementation of EPC Reports in Learning Health Systems Engaged in Quality Initiatives: an EPC Pilot Project on ADHD. Methods Research Report. (Prepared by the Mayo Clinic and Minnesota Evidence-based Practice Center under Contract No. 290-2015-00013-I; 290-2015-00008-I.) AHRQ Publication No. 19(20)-EHC029-EF. Rockville, MD: Agency for Healthcare Research and Quality; October 2019. Posted final reports are located on the Effective Health Care Program search page. DOI: http://doi.org/10.23970/AHRQEPCMETHQUALIMPRFACILITATING.
This report is based on research conducted by the Mayo Clinic and Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No.290-2015-00013-I;290-2015-00008-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.
The information in this report is intended to help healthcare decision makers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.
This report is made available to the public under the terms of a licensing agreement between the author and the Agency for Healthcare Research and Quality. This report may be used and reprinted without permission except those copyrighted materials that are clearly noted in the report. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.
AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.
Persons using assistive technology may not be able to fully access information in this report. For assistance contact vog.shh.qrha@CPE.
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- Facilitating the Implementation of EPC Reports in Learning Health Systems Engage...Facilitating the Implementation of EPC Reports in Learning Health Systems Engaged in Quality Initiatives: an EPC Pilot Project on ADHD
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