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This principle suggests the need to adequately understand the trajectory of patient-centered outcomes before implementing clinical interventions focused on QoL assessment.
From the 'snail' point of view, implementing clinical interventions before their efficacy and safety are rigorously established is morally suspect because it can result in ineffective, wasteful and potentially harmful actions.
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First, our findings clarify why implementing clinical quality interventions can be so difficult.
A logical method of choosing, developing, and implementing clinical decision support interventions is presented that is based on the best available scientific evidence.
For example, hospital doctors discussing medical audit thought that a major barrier was that not all doctors are adequately trained in audit ([ 42]; Audit), while senior primary care clinicians, discussing the cultural changes needed to implement clinical quality interventions in general practice, noted that a barrier was lack of necessary skill in implementing these interventions ([ 43]; General).
The second, which will be the focus of this article, is that we do not understand enough about the factors that make it more or less likely that clinicians will implement clinical quality interventions.
Implementing clinical practice guidelines (CPGs) in healthcare settings is a complex intervention involving both independent and interdependent components.
Some authors have highlighted the difficulty of implementing case management systems or population-based chronic illness management systems, as compared with implementing specific clinical interventions such as clinical practice guidelines [ 18, 46], or the challenges of implementing initiatives to harmonize practices, which require time, adaptation, and open-mindedness [ 47].
Since 2005, PATH has helped Cambodian officials implement clinical and community interventions that integrate diarrhea and pneumonia control, particularly in rural communities where child deaths are highest.
In Haiti, the fellow works side by side with ZL clinicians who are the primary providers of services, accompanying them as they implement clinical mental health interventions and generally supporting the evolving service model.
One component of the program requires eligible providers to implement clinical decision support (CDS) interventions that can improve performance on one or more quality measures pre-selected for each specialty.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com