Heart failure is a major public health problem that increases the vulnerability of older Americans. While adherence to practice guidelines is clearly linked with positive patient outcomes, studies to date demonstrate that practitioner adherence with core recommendations of practice guidelines is deficient. Currently a gap exists in the literature regarding strategies to promote interdisciplinary adherence to these guidelines. The overall goal of the proposed research is to study an innovative strategy to promote interdisciplinary guideline adherence and positive patient outcomes in patients diagnosed with heart failure.
The aims of this study are to: 1) examine interdisciplinary adherence to core recommendations of the AHA/ACC clinical practice guidelines before and after implementation of an automated clinical pathway model and 2) compare patient outcomes before and after implementation of an automated clinical pathway model, integrated with core AHA/ACC guideline recommendations. Two samples of 150 consecutive patients age 65 or older, admitted to the proposed setting with a primary diagnosis of heart failure will be studied, 150 pre-and 150 post-implementation of the automated pathway. Similarly, two groups of 150 consecutive patients age 65 or older admitted to the proposed setting with a primary diagnosis of Pneumonia will be used as a nonequivalent comparison group without an automated pathway intervention. Clinician adherence and selected patient outcomes will be compared between treatment and control groups pre and post pathway using analysis of variance models. The study findings will provide the foundation for more extensive research programs whose findings could be generalized to larger patient populations and health care organizations.
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| Dykes, Patricia C; Currie, Leanne M; Cimino, James J (2003) Adequacy of evolving national standardized terminologies for interdisciplinary coded concepts in an automated clinical pathway. J Biomed Inform 36:313-25 |
