Dissemination of Professional Parameters of Care. Abstract, Executive Summary andFinal Report

摘要

Education concerning Parameters has an effect on those attending workshops andusing self-stay modules. There was greater knowledge of purposes and goals, organization and clinical topics. There was measurable impact on clinical judgment and behavior relative to simulated clinical situations. Panel surveys measured changes in knowledge and attitudes. Understanding of the use of Parameter differed by intervention group. Changes varied significantly among interventions for questions related to adherence to, and review and revision of parameters. A stronger effect was attributable to workshops than to modules. Retrospective review of patient records before and after interventions measured behavioral response. Actual use of informed consent (60%) contrast with Self-study Module data reporting 88% of surgeons claiming routine use. Employment of forms to document clinical data was variable. Offices using forms performed better than those not using them. There are important differences in practice patterns among offices. In this study only documentation of behavior was evaluated, and not behavior itself. If a given practice was reported in the record it provided evidence that it was followed, the reversed is not true. Parameters have had clear effects among surgeons but have not affected their behavior with respect to recordkeeping. Significant changes in behavior will require dissemination of information to surgeons about their actual performance rather than general information about Parameters.