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Implementation of the Asthma Practice Guideline in the Army Medical Department

Evaluation of Process and Effects

Cover: Implementation of the Asthma Practice Guideline in the Army Medical Department

By: Donna O. Farley, Shan Cretin, Georges Vernez, Suzanne Pieklik, Elaine Quiter, J. Scott Ashwood, Wenli Tu

In partnership with the Army Medical Department (AMEDD), RAND researchers worked to implement clinical practice guidelines in treatment of three common ailments (asthma, diabetes, and low back pain). This report is an evaluation of the asthma practice guideline demonstration. It documents the extent to which intended actions were implemented, assesses short-term effects on clinical practices, and measures the quality and limitations of available data for monitoring practice improvements and clinical outcomes. The authors found that, although the implementation scored some notable successes, resource limitations and organizational barriers curbed overall progress. They conclude that allowing for flexibility, monitoring the facilities consistently, and training providers thoroughly are the keys to implementing the practice guidelines throughout AMEDD. The also concluded that patient education was an area in need of improvement.

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Pages: 210

ISBN/EAN: 0-8330-3773-0

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Contents

Chapter One:
Introduction

Chapter Two:
Introduction

Chapter Three:
Asthma Populations and Practices at the Baseline

Chapter Four:
The Guideline Implementation Process

Chapter Five:
Effects of Guideline Implementation

Chapter Six:
Synthesis of Findings from the Demonstration

Appendix A:
Hypotheses for Effects of Improved Asthma Care Practices

Appendix B:
Evaluation Methodology

Appendix C:
Modules of the Climate Survey

Appendix D:
Physician Questionnaire

Appendix E:
Analyses of Asthma Metrics

The research described in this report was sponsored by the United States Army and conducted by the RAND Arroyo Center.

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