(provided by the applicant): The goal of evidence-based practice is to make clinical decisions based on both the best evidence-based health information and the values and informed preferences of the patient. Clinicians and patients may not have timely access to high-quality comparative effectiveness research when making management decisions, leading to haphazard recommendations of both effective and ineffective care. The provision of evidence about management options and their pros and cons using shared decision making tools called decision aids represents a highly responsive and innovative solution to the challenge of disseminating evidence-based health information. We propose to contribute to the science and practice of disseminating evidence-based health information by 1) building a dissemination partnership between Mayo Clinic, experts in decision aid research, and the Institute for Clinical Systems Improvement (ICSI), experts in implementation 2) developing a theory supported implementation toolkit to guide and support primary care practices on their implementation of decision aids for patients with chronic conditions, and 3) evaluating this toolkit to identify effective tactics for sustainable implementation within practices serving rural, suburban, and inner city patients. Upon completion of these aims we will have an effective approach to disseminating evidence-based health information at the point of care through decision aids for patients with chronic conditions, and formed a sustainable partnership to deploy this approach in a manner consistent with AHRQ objectives and RFA-HS- 12-005.
We know that patients, particularly those with chronic conditions, do not regularly make decisions based on their review of evidence-based medical information to consider in light of their values and preferences. Decision aids have been proven as an effective tool to accomplish this end. We intend to build a sustainable partnership, create an implementation toolkit, and evaluate the toolkit to bridge the implantation gap for patients with chronic conditions to benefit from evidence-based care.