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Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative.

Publication ,  Journal Article
Blomkalns, AL; Roe, MT; Peterson, ED; Ohman, EM; Fraulo, ES; Gibler, WB
Published in: Acad Emerg Med
November 2007

Translating research results into routine clinical practice remains difficult. Guidelines, such as the 2002 American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Unstable Angina and non-ST-segment elevation myocardial infarction, have been developed to provide a streamlined, evidence-based approach to patient care that is of high quality and is reproducible. The Can Rapid Risk Stratification of Unstable Angina Patients Suppress ADverse Outcomes with Early Implementation (CRUSADE) Quality Improvement Initiative was developed as a registry for non-ST-segment elevation acute coronary syndromes to track the use of guideline-based acute and discharge treatments for hospitalized patients, as well as outcomes associated with the use of these treatments. Care for more than 200,000 patients at more than 400 high-volume acute care hospitals in the United States was tracked in CRUSADE, with feedback provided to participating physicians and hospitals regarding their performance over time and compared with similar institutions. Such access to data has proved important in stimulating improvements in non-ST-segment elevation acute coronary syndromes care at participating hospitals for delivery of acute and discharge guideline-based therapy, as well as improving outcomes for patients. Providing quality improvement methods such as protocol order sets, continuing education programs, and a CRUSADE Quality Improvement Initiative toolbox serve to actively stimulate physician providers and institutions to improve care. The CRUSADE Initiative has also proven to be a fertile source of research in translation of treatment guidelines into routine care, resulting in more than 52 published articles and 86 abstracts presented at major emergency medicine and cardiology meetings. The cycle for research of guideline implementation demonstrated by CRUSADE includes four major steps--observation, intervention, investigation, and publication--that serve as the basis for evaluating the impact of any evidence-based guideline on patient care. Due to the success of CRUSADE, the American College of Cardiology combined the CRUSADE Initiative with the National Registry for Myocardial Infarction ST-segment elevation myocardial infarction program to form the National Cardiovascular Data Registry-Acute Coronary Treatment & Intervention Outcomes Network Registry beginning in January 2007.

Duke Scholars

Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

November 2007

Volume

14

Issue

11

Start / End Page

949 / 954

Location

United States

Related Subject Headings

  • Risk Assessment
  • Registries
  • Practice Guidelines as Topic
  • Outcome Assessment, Health Care
  • Humans
  • Hospital Mortality
  • Health Services Research
  • Guideline Adherence
  • Emergency & Critical Care Medicine
  • Acute Coronary Syndrome
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Blomkalns, A. L., Roe, M. T., Peterson, E. D., Ohman, E. M., Fraulo, E. S., & Gibler, W. B. (2007). Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative. Acad Emerg Med, 14(11), 949–954. https://doi.org/10.1197/j.aem.2007.06.017
Blomkalns, Andra L., Matthew T. Roe, Eric D. Peterson, E Magnus Ohman, Elizabeth S. Fraulo, and W Brian Gibler. “Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative.Acad Emerg Med 14, no. 11 (November 2007): 949–54. https://doi.org/10.1197/j.aem.2007.06.017.
Blomkalns AL, Roe MT, Peterson ED, Ohman EM, Fraulo ES, Gibler WB. Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative. Acad Emerg Med. 2007 Nov;14(11):949–54.
Blomkalns, Andra L., et al. “Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative.Acad Emerg Med, vol. 14, no. 11, Nov. 2007, pp. 949–54. Pubmed, doi:10.1197/j.aem.2007.06.017.
Blomkalns AL, Roe MT, Peterson ED, Ohman EM, Fraulo ES, Gibler WB. Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative. Acad Emerg Med. 2007 Nov;14(11):949–954.
Journal cover image

Published In

Acad Emerg Med

DOI

EISSN

1553-2712

Publication Date

November 2007

Volume

14

Issue

11

Start / End Page

949 / 954

Location

United States

Related Subject Headings

  • Risk Assessment
  • Registries
  • Practice Guidelines as Topic
  • Outcome Assessment, Health Care
  • Humans
  • Hospital Mortality
  • Health Services Research
  • Guideline Adherence
  • Emergency & Critical Care Medicine
  • Acute Coronary Syndrome