Outcomes were inspired by using the RE-AIM framework: reach, the proportion of patients receiving lifestyle promotion; effectiveness, self-reported attitudes and competency among staff; adoption, proportion of staff reporting daily practice of lifestyle promotion and referral; and implementation, of the coordinated care model.
Our observed increase in CKD patient co-management is similar to previous reports documenting increased nephrology referrals following implementation of routine eGFR reporting [ 8, 26- 28].
In spite of the importance of referral behavior for implementation of effective interventions only few studies evaluated the effect of implementation strategies on physicians' outpatient referral behavior [ 25].
We believe that early referral and early implementation of a protocol-driven ECMO technique, with better understanding of its physiological and management principles, might improve the outcomes of patients with severe Legionella pneumonia.
The instrument includes a referral protocol for implementation in the preventive health examinations of the Public Health Services Rotterdam.
Few previous studies have examined changes in referral patterns following implementation of nursing BPGs.
Finally, the lack of prospective studies confirming clinical effectiveness of the referral algorithms after implementation has also previously been noted.
This article describes findings from cycle 3, implemented during the period 2003 4, and addresses one of our research questions: Were there changes in referral outcomes following implementation of six BPGs (asthma, breastfeeding, delirium-dementia-depression, smoking cessation, venous leg ulcers and diabetes foot care)?
This is similar to findings by Richards et al [ 8] who noted that despite the marked increase in renal referrals following eGFR implementation, only 33% of non-referred CKD 4-5 patients were referred in the following 12 months.
to explore the opinions of midwives on the desirability of preconception care for all couples contemplating pregnancy, their willingness to introduce preconception care to midwifery practice and, if it were to be implemented, the necessary conditions, including knowledge, postgraduate education and referral possibilities for successful implementation in the community.
