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Evaluation & the Health Professions, Vol. 29, No. 1, 65-88 (2006)
DOI: 10.1177/0163278705284443
© 2006 SAGE Publications

The Logic Behind a Multimethod Intervention to Improve Adherence to Clinical Practice Guidelines in a Nationwide Network of Primary Care Practices

Chris Feifer

University of Southern California

Steven M. Ornstein

Ruth G. Jenkins

Andrea Wessell

Medical University of South Carolina

Sarah T. Corley

Practice Partner Research Network

Lynne S. Nemeth

Loraine Roylance

Paul J. Nietert

Heather Liszka

Medical University of South Carolina

The gap between evidence-based guidelines for clinical care and their application in medical settings is well established and widely discussed. Effective interventions are needed to help health care providers reduce this gap. Whereas the development of clinical practice guidelines from biomedical and clinical research is an example of Type 1 translation, Type 2 translation involves successful implementation of guidelines in clinical practice. This article describes a multimethod intervention that is part of a Type 2 translation project aimed at increasing adherence to clinical practice guidelines in a nationwide network of primary care practices that use a common electronic medical record (EMR). Practice performance reports, site visits, and network meetings are intervention methods designed to stimulate improvement in practices by addressing personal and organizational factors. Theories and evidence supporting these interventions are described and could prove useful to others trying to translate medical research into practice. Additional theory development is needed to support translation in medical offices.

Key Words: primary care • quality improvement • evaluation • translation


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