Implementation of the Diabetes Practice Guideline in the Army Medical Department - Final Evaluation

THE ARTS CHILD POLICY CIVIL JUSTICE EDUCATION ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND TECHNOLOGY SUBSTANCE ABUSE TERRORISM AND HOMELAND SECURITY TRANSPORTATION AND INFRASTRUCTURE WORKFORCE AND WORKPLACE This PDF document was made available from www.rand.org as a public service of the RAND Corporation. Jump down to document6 The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. Support RAND Purchase this document Browse Books & Publications Make a charitable contribution For More Information Visit RAND at www.rand.org Explore RAND Arroyo Center View document details Limited Electronic Distribution Rights This document and trademark(s) contained herein are protected by law as indicated in a notice appearing later in this work. This electronic representation of RAND intellectual property is provided for non-commercial use only. Permission is required from RAND to reproduce, or reuse in another form, any of our research documents. This product is part of the RAND Corporation monograph series. RAND monographs present major research findings that address the challenges facing the public and private sectors. All RAND mono-graphs undergo rigorous peer review to ensure high standards for research quality and objectivity. Implementation of the Diabetes Practice Guideline in the Army Medical Department Final Evaluation Donna O. Farley Georges Vernez Kathryn J. Dolter Suzanne Pieklik Wenli Tu J. Scott Ashwood Shan Cretin Prepared for the United States Army Approved for public release; distribution unlimited The research described in this report was sponsored by the United States Army under Contract No. DASW01-01-C-0003. Library of Congress Cataloging-in-Publication Data Implementation of the diabetes practice guideline in the Army Medical Department : final evaluation / Donna O. Farley ... [et al.]. p. cm. Includes bibliographical references. “MG-277.” ISBN 0-8330-3769-2 (pbk.) 1. Diabetes—Treatment—Standards—United States. 2. Military hospitals—United States. 3. Medicine, Military—United States. 4. United States. Army Medical Dept. I. Farley, Donna. RA645.D5I476 2005 362.196`462`00973—dc22 2005005240 The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a registered trademark. © Copyright 2005 RAND Corporation All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from RAND. Published 2005 by the RAND Corporation 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 1200 South Hayes Street, Arlington, VA 22202-5050 201 North Craig Street, Suite 202, Pittsburgh, PA 15213-1516 RAND URL: http://www.rand.org/ To order RAND documents or to obtain additional information, contact Distribution Services: Telephone: (310) 451-7002; Fax: (310) 451-6915; Email: order@rand.org Preface The RAND Corporation has worked with the Army Medical Department (AMEDD) on a project entitled “Implementing Clinical Practice Guidelines in the Army Medical System.” This project was undertaken to assist the AMEDD in developing and testing methods to effectively implement clinical practice guidelines in Army military treatment facilities (MTFs), with the goal being to achieve consistent and quality clinical practices across the Army health system. Three demonstrations were conducted to test and refine methods before embarking on full guideline implementation across the Army health system. These demonstrations tested use of guidelines for primary care management of low back pain, asthma, and diabetes. This report presents the final findings from the RAND evalua-tion of the diabetes practice guideline demonstration, which was conducted in 2000 and 2001. The evaluation included both an assessment of the implementation process and a quantitative analysis of changes in clinical practices. The quantitative analysis was per-formed to document the extent to which intended actions were actu-ally implemented by the MTFs, assess short-term effects on clinical practices, develop and test metrics and measurement methods that can be adopted by the AMEDD for routine monitoring of progress, and assess the quality and limitations of available data for monitoring practice improvements and clinical outcomes. Recommendations for future actions by the AMEDD are presented. This report is one of three final reports being generated in this project. It should be of interest to anyone concerned with military iii ... - tailieumienphi.vn