AHRQ EPC Series on Improving Translation of Evidence: Use of a Clinical Pathway for C. Difficile Treatment to Facilitate the Translation of Research Findings into Practice

摘要

Background: In 2018 the Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC)Program issued a call for strategies to disseminate AHRQ EPC systematic reviews. In this pilot, findings from the 2016AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via acloud-based platform and electronic health record (EHR).Methods: An existing 10-step framework was used for developing and disseminating evidence-based clinical pathways.The development of the EHR intervention was informed by the Five Rights model for clinical decision support and humancomputerinteraction design heuristics. The researchers used observations and time measurements to describe the impact ofthe EPC report on pathway development and examined provider adoption using counts of pathway views.Results: Two main themes emerged: (1) discrepancies between the EPC report and existing guidelines prompted criticaldiscussions about available treatments, and (2) lack of guideline and pathway syntheses in the EPC report necessitated a rapidliterature review. Pathway development required 340 hours: 205 for the rapid literature review, 63 for pathway developmentand EHR intervention design, and 5 for technical implementation of the intervention. Pathways were viewed 1,069 timesthrough the cloud-based platform and 47 times through a hyperlink embedded in key EHR ordering screens.Conclusion: Pathways can be an approach for disseminating AHRQ EPC report findings within health care systems; how-ever, reports should include guideline and pathway syntheses to meet their full potential. Embedding hyperlinks to pathwaycontent within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.