Uptake of validated clinical practice guidelines: experience with implementing the Ottawa Ankle Rules - 26/08/11
, Deborah Wilson, MN §, Brian H Rowe, MD, MSc †, ⁎ 
, Damon C Mayes, MSc ‡, Thomas Noseworthy, MD, MSc, MPH ¶ Division of Emergency Medicine, Edmonton, Alberta, Canada Abstract |
This study examined whether emergency physicians (EPs) exposed to multiple dissemination strategies for the Ottawa Ankle Rules (OARs) would reduce extremity radiography use. We conducted a prospective cohort study comparing intervention (n = 2) with control (n = 2) hospitals over a 2-year period. All EPs received the paper-based rules during the run-in phase; EPs in the intervention hospitals were also subjected in sequence to valid dissemination approaches. Provincewide dissemination of the OARs did not decrease radiography during the run-in period (92% vs. 93%; P = .36). Sequential directed education and personalized feedback strategies failed to reduce radiographic ordering rates (P = .54) or the ordering of both foot and ankle radiographs (P = .11) over time. The use of radiography did not decrease despite the use of a variety of dissemination strategies. Additional research is required to determine the most effective methods of incorporating guidelines into emergency practice.
Le texte complet de cet article est disponible en PDF.Keywords : Ankle injuries, emergency, practice guidelines, radiography
Plan
 | Supported by the Capital Health Authority, Alberta Medical Association (AMA) Clinical Practice Guideline Program, and the AMA-Medical Services Branch Grant Program. Dr Rowe is supported by the Canadian Institute of Health Research (CIHR; Ottawa, Ontario) as a Canada Research Chair. |
Vol 22 - N° 3
P. 149-155 - mai 2004 Retour au numéro
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