Implementation of the asthma practice guideline in the Army Medical Department : evaluation of process and effects.

"RAND Arroyo Center."

"Center for Military Health Policy Research."

Includes bibliographical references (pages 173-176).

Introduction -- Methods and data -- Asthma populations and practices at the baseline -- The guideline implementation process -- Effects of guideline implementation -- Synthesis of findings from the demonstration -- Appendix A. Hypotheses for effects of improved asthma care practices -- Appendix B. Evaluation methodology -- Appendix C. Modules of the climate survey -- Appendix D. Physician questionnaire -- Appendix E. Analyses of asthma metrics.

In partnership with the Army Medical Department (AMEDD), RAND researchers worked to implement clinical practice guidelines in treatment of three common ailments (asthma, diabetes, and low back pain). This report is an evaluation of the asthma practice guideline demonstration. It documents the extent to which intended actions were implemented, assesses short-term effects on clinical practices, and measures the quality and limitations of available data for monitoring practice improvements and clinical outcomes. The authors found that, although the implementation scored some notable successes, resource limitations and organizational barriers curbed overall progress. They conclude that allowing for flexibility, monitoring the facilities consistently, and training providers thoroughly are the keys to implementing the practice guidelines throughout AMEDD. The also concluded that patient education was an area in need of improvement.

Army. DASW01-01-C-0003. AR200 5A02. Ar200 1007

Supersedes RAND/DRR-2872-A.

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