HIT Asthma: A Tale of Woe and Enlightenment
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Describes challenges encountered in converting clinical practice guidelines for asthma into electronic decision support software. Presented at annual mtg of AHRQ, Sept 08.
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· Variations in practice within the setting
· Variations in practice compared to community standard
· Current practice that has not been validated
· Financial concerns
5. What are the PICO components?
P – (Patient, population, or problem)
I – (Intervention)
C – (Comparison with other interventions, if foreground question)
O – (Outcomes are qualitative or quantitative measures to determine the success of change)
6. Initial EBP question ❑ Background ❑ Foreground
Johns Hopkins Nursing Evidence-Based Practice
Appendix B: Question Development Tool
Johns Hopkins Nursing Evidence-Based Practice
Appendix B: Question Development Tool
7. List possible search terms, databases to search, and search strategies.
8. What evidence must be gathered? (Check all that apply.)
· Publications (e.g., EBSCOHost, PubMed, CINAHL, Embase)
· Standards (regulatory, professional, community)
· Guidelines
· Organizational data (e.g., QI, financial data, local clinical expertise, patient/family preferences)
· Position statements
9. Revised EBP question
(Revisions in the EBP question may not be evident until after the initial evidence review; the revision can be in the background question or a change from the background to a foreground question.)
10. Outcome measurement plan
What will we measure?
(structure, process, outcome measure)
How will we measure it?
(metrics are expressed as rate or percent)
How often will we measure it?
(frequency)
Where will we obtain the data?
Who will collect the data?
To whom will we report the data?
Directions for Use of the Question Development ToolPurpose
This form is used to develop an answerable EBP question and to guide the team in the evidence search process. The question, search terms, search strategy, and sources of evidence can be revised as the EBP team refines the EBP question.
What is the problem, and why is it important?
Indicate why the project was undertaken. What led the team to seek evidence? Ensure that the problem statement defines the actual problem and does not include a solution. Whenever possible, quantify the extent of the problem. Validate the final problem description with practicing staff. It is important for the inter- professional team to take the time together to reflect, gather information, observe current practice, listen to clinicians, visualize how the process can be different or improved, and probe the problem description in order to develop a shared under- standing of the problem.
What is the current practice?
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1) The document discusses the steps of evidence-based practice (EBP) research and searching PubMed effectively to find evidence. It focuses on converting a clinical question into PICO format and using Medical Subject Headings (MeSH) terms to plan and conduct searches.
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Chcpol501 a session five 250311
This document discusses how to develop a PICO question to help determine the most relevant information for deciding on an evidence-based intervention for a client. It provides examples of factors to consider for the patient/client population (P), intervention/treatment (I), comparison intervention (C), and outcomes (O). It also introduces some key resources for finding evidence-based guidelines and systematic reviews, such as those from SAMHSA and Cochrane, to help answer PICO questions and identify best practices. Stakeholder involvement is emphasized when implementing a new evidence-based practice.
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HIT Asthma: A Tale of Woe and Enlightenment
- 1. AHRQ Annual Meeting 09SEP08 HIT Asthma a tale of woe and enlightenment Yiscah Bracha, M.S. [email_address]
- 17. From: Expert Panel Guidelines To: Electronic Clinical Decision Support:
- 22. More peaks into the software mind…
- 23. Human vs software “minds”: No tolerance for ambiguity Can tolerate ambiguity Precise meaning of words required Approximate meanings of words OK Counterfactuals not possible Counterfactuals entertained Linear, step-by-step “ Gestalt” Series of nested and explicit if-then statements Fast, unarticulated thought processes Software Humans
- 26. From this….
- 28. … to this
- 33. Different words for same ideas: I thought my child would die ED visit Exacerbation My top number on the meter What you can and should be able to blow FEV 1 actual vs. predicted Purple inhaler Daily controller Long-acting beta agonist Ordinary: Clinical: Academic:
- 44. … and now, Bob Mayes our Task Order Officer