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AHRQ EPC Pilot Projects Summary: Improving Health Systems' Access to High Quality Evidence

Series Overview

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Purpose of Report

This report summarizes nine Evidence-based Practice Center (EPC) pilot projects that developed companion products intended to accelerate the uptake and implementation of evidence from EPC reviews in health systems.

Key Messages

  • EPCs developed nine companion products, which included dissemination products (e.g., short report summaries), interactive data visualization products (e.g., interactive maps), and implementation products (e.g., electronic health tools and decision aids) to help health systems use the findings from EPC reviews.
  • Developing companion products to EPC evidence reviews required additional time, resources and information, and expertise.
  • Before starting an evidence review, working with health systems to understand the needs and decisional dilemma they are facing will allow systematic reviewers to incorporate additional context specific information to improve usefulness for health systems.
  • Companion products may help health systems use findings from AHRQ evidence reviews. Products should prioritize clear writing, meaningful tables and graphs, and tailor the evidence to the needs of a partner.

Structured Abstract

Introduction. Health systems want to use the best evidence available in their decision making, but they have limited time and resources to identify and evaluate evidence from systematic reviews. EPCs initiated a series of pilot projects (described in Table 1 below) in order to identify effective approaches to accelerate the uptake and implementation of evidence from systematic reviews.

Methods. EPCs developed, piloted, and evaluated nine products to facilitate dissemination or implementation of information from selected EPC systematic reviews in health systems. They conducted interviews with their health system partners to evaluate potential usability of their product. While the pilot projects were being evaluated, the EPCs met in person and used a nominal group technique to develop recommendations for the EPC Program, based on their lessons learned. After completion of reports and evaluations, the SRC conducted a content analysis of EPC pilot reports and of a semi-structured survey from all EPC projects.

Results. EPC products varied widely, ranging from dissemination products (e.g., short summaries of EPC reports) through interactive data visualization products (e.g., interactive maps) to implementation products (e.g., electronic health tools and decision aids). Most EPCs required additional expertise beyond the typical systematic review team and several needed to synthesize additional literature in order to develop their product. All required additional time to develop the products (range from 20 hours to 2,850 hours), which corresponded to the amount of additional information or expertise needed beyond the typical systematic review team. Dissemination products summarized results from systematic reviews and required on average 57 hours to develop. Interactive data visualizations used technology or software to enable an interactive interface with findings of reports and required on average 152 hours to develop. Implementation products helped health systems implement evidence into practice, and required on average 1,077 hours to develop. All but one health system reported the products would help them use evidence from systematic reviews in practice. Health systems found projects likely to improve dissemination and implementation of evidence reports by tailoring the information to suit health system needs. The only health system that reported the product would not help them implement evidence into practice was not currently facing a decisional dilemma related to the healthcare topic.

Conclusions. Companion products may help health systems use findings from AHRQ evidence reviews. Dissemination products required the least time investment, while implementation products required the most. Alternative presentation formats may allow expert users and stakeholders to interact with evidence synthesis in a more meaningful and useful way. When planning a companion product, authors should work with health systems to understand the needs and decisional dilemmas, so that context-specific information can be gathered during the review and the report can be tailored to fit evidence needs. Companion products can augment reports to improve usefulness, but require additional time and resources. Different formats may be useful for different audiences and tailored content may be more useful than general summaries. Further research is needed to understand which formats are most effective in which contexts.

Table 1. Description of piloted products.

EPC Program 2017–2018 Methods Workgroup

Piloted Dissemination Product

Pilot Report Title

Clinical Topic and EPC Report

Brown, Duke, Minnesota EPC

Thomas A. Trikalinos, MD
Mary Butler, Ph.D., MBA
Gillian Sanders-Schmidler, Ph.D.

Interactive Presentation

Web Interactive Presentation of EPC Reports and Mapping to Quality Measures

Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update

ECRI Institute–Penn Medicine (ECRI-Penn)

Emilia Flores, Ph.D., RN

EMR Clinical Practice Pathway

Use of a Clinical Pathway To Facilitate the Translation and Utilization of AHRQ EPC Report Findings

Early Diagnosis, Prevention, and Treatment of Clostridium difficile

Johns Hopkins University

Karen A. Robinson, Ph.D.

Key messages, newsletters, evidence to decision framework

Disseminating Findings From EPC Reports: Pilot Project of Three Products

Contrast-Induced Nephropathy: Comparative Effects of Different Contrast Media

Kaiser Permanente Research Affiliates (KPRA), Southern California EPC (SCEPC)

Jennifer S. Lin, M.D., MCR
Lisa Rubenstein, M.D., MS

Clinical Operations Evidence Review (COER) Cyberseminar

Linking Evidence Reviews to Organizational Guideline Planning

Screening for Abnormal Glucose and Type 2 Diabetes Mellitus: A Systematic Review to Update the 2008 U.S. Preventive Services Task Force Recommendation

Mayo Clinic EPC

M. Hassan Murad, M.D., MPH

Clinical and health system encounter decision aid

EPC Pilot Project: A Dual Approach To Facilitate Health Systems Uptake of Evidence Synthesis Reports. Anxiety in Children

Anxiety in Children

Pacific Northwest EPC

Annette M. Totten, Ph.D.

MAGICapp and Tableau data visualization

Improving Access to and Usability of Systematic Review Data for Health Systems Guidelines Development

Noninvasive, Nonpharmacological Treatment for Chronic Pain

RTI International—University of North Carolina (RTI-UNC) EPC

Daniel E. Jonas, M.D., MPH

EMR tool Implementation package

Development of a Primary Care Guide for Implementing Evidence-Based Screening and Counseling for Unhealthy Alcohol Use With Epic-Based Electronic Health Record Tools: A Pilot Dissemination Project

Screening, Behavioral Counseling, and Referral in Primary Care to Reduce Alcohol Misuse

University of Alberta EPC

Lisa Hartling, Ph.D.

1 & 3 page summaries

Development and Usability Testing of EPC Evidence Review Dissemination Summaries for Health Systems Decisionmakers

Strategies to improve mental health care for children and adolescents

First and second-generation antipsychotics in children and young adults

University of Connecticut EPC

C. Michael White, Pharm.D., FCP, FCCP

Quality Measure Index

Assessing the Impact of Indexing Performance Measure Codes on the Perceived Value of EPC Reports to Health Systems

Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update

Citation

Suggested citation: Fiordalisi CV, Borsky A, Chang S, Gerrity M, Schmidt AM, Guise JM. Improving Health Systems' Access to High-Quality Evidence: AHRQ EPC 2018 Pilot Projects Summary. Methods Research Report (Prepared by the Scientific Resource Center under Contract No. 290-2017-00003C). AHRQ Publication No.19-EHC015-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2019. Posted final reports are located on the Effective Health Care Program search page. DOI: https://doi.org/10.23970/AHRQEPCMETHENGAGESUMMARY.