Qual Saf Health Care
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Qual Saf Health Care · Feb 2007
Randomized Controlled Trial Multicenter StudyMultifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness.
To evaluate clinical and cost effectiveness of implementing evidence-based guidelines for the prevention of stroke. ⋯ Implementation of evidence-based guidelines improved the quality of primary care for atrial fibrillation and TIA. The intervention was feasible and very cost effective. Key components of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication and use of established networks and opinion leaders.
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Qual Saf Health Care · Feb 2007
Multicenter StudyInfluencing referral practice using feedback of adherence to NICE guidelines: a quality improvement report for dyspepsia.
Rising demand and increasing waiting times for upper gastrointestinal endoscopy (gastroscopy). ⋯ Referral assessment can be successfully introduced and shows promise as a way of improving the quality of referrals and reducing demand. Hospital clinicians are more resistant than GPs to referral assessment but nevertheless responded to the feedback by reducing their endoscopy gastroscopy requests. Most such referrals are generated in hospitals rather than in primary care: this finding has important implications for demand management.