Highly effective treatments are often underused in clinical practice, and some commonly used treatments are ineffective or even harmful. Many studies have documented the potential improvements in healthcare delivery and patient outcomes if clinicians were able to more completely apply the evidence to their medical decisions. Academic Detailing is direct educational outreach to clinicians, providing them with information in a concise, clear, impartial, and user-friendly format that focuses on practical information needed to improve patient outcomes. Originally developed with support from AHRQ's predecessor agency, Academic Detailing has been tested in scores of clinical trials that have proven its ability to improve clinician behavior. In 2010 a team at Brigham and Women's Hospital established the National Resource Center for Academic Detailing (NaRCAD) as part of AHRQ's iADAPT initiative to disseminate evidence-based practices more widely. Over the past 3 years NaRCAD has worked with organizations from around the US to help implement and expand programs of Academic Detailing and related educational outreach to improve patient care and outcomes. NaRCAD has trained educators in the techniques of Academic Detailing, conducted data analysis for public and private programs seeking to identify opportunities for care improvement, provided assistance with development and editing of educational documents to be used in interventions, advised organizations on the planning of new Academic Detailing programs, and created an ongoing network of organizations that are using Academic Detailing and related strategies. We now propose to sustain and expand the reach of NaRCAD. We will continue to provide multiple dimensions of support to stakeholders seeking to establish or augment Academic Detailing programs. In addition to the services described above we will provide guidance on how to interpret the new information that will emerge from patient-centered outcomes research over the coming years. We will continue to provide training courses in the techniques of Academic Detailing, and will now expand the geographic scope by conducting one course per year outside of Boston. We also will develop a new course on managing an Academic Detailing program, responding to feedback from stakeholders with whom we have engaged in the first 3 years of NaRCAD. Four model partnerships, one for each project year, have been developed with organizations representing a range of patient populations and healthcare settings: nursing home patients, patients in safety net primary care settings in Alabama, patients in the Department of Defense health system, and high-risk patients served by the San Francisco Department of Public Health. By combining a continuation and intensification of NaRCAD's successful prior activities with specific new initiatives involving diverse stakeholders, our proposed work will dramatically increase the reach of Academic Detailing and other outreach educational interventions, allowing for broad-based improvement in healthcare delivery and patient outcomes.

Public Health Relevance

Many opportunities exist to improve healthcare delivery and outcomes by helping clinicians to understand the evidence and apply it in practice and these opportunities will grow as new results of patient-centered outcomes research (PCOR) become available. The National Resource Center for Academic Detailing (NaRCAD), supported by AHRQ, has worked with organizations across the US to develop outreach educational programs to improve evidence-based practice. Sustaining and expanding the work of NaRCAD will leverage AHRQ's support to help many additional organizations and clinicians develop approaches that use PCOR results to improve healthcare delivery and patient outcomes.

National Institute of Health (NIH)
Research Demonstration and Dissemination Projects (R18)
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Special Emphasis Panel (ZHS1)
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Delamare, Jan
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Brigham and Women's Hospital
United States
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