Implementation of the Asthma Practice Guideline in the Army Medical Department
Evaluation of Process and Effects
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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.
Table of 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
Research conducted by
The research described in this report was sponsored by the United States Army and conducted by the RAND Arroyo Center.
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