Using audit and feedback to increase clinician adherence to clinical practice guidelines in brain injury rehabilitation: A before and after study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
14
08
2018
accepted:
23
02
2019
entrez:
14
3
2019
pubmed:
14
3
2019
medline:
4
12
2019
Statut:
epublish
Résumé
This study evaluated whether frequent (fortnightly) audit and feedback cycles over a sustained period of time (>12 months) increased clinician adherence to recommended guidelines in acquired brain injury rehabilitation. A before and after study design. A metropolitan inpatient brain injury rehabilitation unit. Clinicians; medical, nursing and allied health staff. Fortnightly cycles of audit and feedback for 14 months. Each fortnight, medical file and observational audits were completed against 114 clinical indicators. Adherence to guideline indicators before and after intervention, calculated by proportions, Mann-Whitney U and Chi square analysis. Clinical and statistical significant improvements in median clinical indicator adherence were found immediately following the audit and feedback program from 38.8% (95% CI 34.3 to 44.4) to 83.6% (95% CI 81.8 to 88.5). Three months after cessation of the intervention, median adherence had decreased from 82.3% to 76.6% (95% CI 72.7 to 83.3, p<0.01). Findings suggest that there are individual indicators which are more amenable to change using an audit and feedback program. A fortnightly audit and feedback program increased clinicians' adherence to guideline recommendations in an inpatient acquired brain injury rehabilitation setting. We propose future studies build on the evidence-based method used in the present study to determine effectiveness and develop an implementation toolkit for scale-up.
Identifiants
pubmed: 30865685
doi: 10.1371/journal.pone.0213525
pii: PONE-D-18-23912
pmc: PMC6415863
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0213525Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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