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Improving occupational physicians' adherence to a practice guideline: Feasibility and impact of a tailored implementation strategy
Joosen,M.C.W. van Beurden-Berkers,K.M. Terluin,B. van Weeghel,J. Brouwers,E.P.M. van der Klink,J.J.L.
Joosen,M.C.W.
van Beurden-Berkers,K.M.
Terluin,B.
van Weeghel,J.
Brouwers,E.P.M.
van der Klink,J.J.L.
Abstract
Background Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived by occupational physicians (OPs). Feasibility and impact on OPs’ barriers were evaluated. Methods OPs received 8 training-sessions in small peer-learning groups, aimed at discussing the content of the guideline and their perceived barriers to adhere to guideline recommendations; finding solutions to overcome these barriers; and implementing solutions in practice. The training had a plan-do-check-act (PDCA) structure and was guided by a trainer. Protocol compliance and OPs’ experiences were qualitatively and quantitatively assessed. Using a questionnaire, impact on knowledge, attitude, and external barriers to guideline adherence was investigated before and after the training. Results The training protocol was successfully conducted; guideline recommendations and related barriers were discussed with peers, (innovative) solutions were found and implemented in practice. The participating 32 OPs were divided into 6 groups and all OPs attended 8 sessions. Of the OPs, 90% agreed that the peer-learning groups and the meetings spread over one year were highly effective training components. Significant improvements (p < .05) were found in knowledge, self-efficacy, motivation to use the guideline and its applicability to individual patients. After the training, OPs did not perceive any barriers related to knowledge and self-efficacy. Perceived adherence increased from 48.8% to 96.8% (p < .01). Conclusions The results imply that an implementation strategy focusing on perceived barriers and tailor-made implementation interventions is a feasible method to enhance guideline adherence. Moreover, the strategy contributed to OPs’ knowledge, attitudes, and skills in using the guideline. As a generic approach to overcome barriers perceived in specific situations, this strategy provides a useful method to guideline implementation for other health care professionals too.
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2015
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Joosen, M C W, van Beurden-Berkers, K M, Terluin, B, van Weeghel, J, Brouwers, E P M & van der Klink, J J L 2015, 'Improving occupational physicians' adherence to a practice guideline : Feasibility and impact of a tailored implementation strategy', BMC Medical Education, vol. 15, 82. https://doi.org/10.1186/s12909-015-0364-8
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info:eu-repo/semantics/openAccess