Opening Session at NYAM 2010
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Transcript of Opening Session at NYAM 2010
PROGRAM- August 11, 2010 8:00am Morning Plenaries Peter Wyer MD
Suzana Alves Silva MD MSc 9:00am Seminar I 9:45am BREAK10:00am Small Group Session11:30am LUNCH
12:30 pm Afternoon Plenaries Jo Ivey Boufford MD Sharon Straus MD MSc Rita Charon MD PhD 2:00 pm Seminar II 3:00pm BREAK 3:15 pm Small Group Session 5:00 pm OPENING RECEPTION
TEACHING EVIDENCE ASSIMILATION FOR COLLABORATIVE HEALTH CARE
ACKNOWLEDGEMENTS
SEBHC TEAM INTERNATIONAL PLANNERS* NYAM TEAM
David Adinaro Elie Akl Amy Kline Saadia Akhtar * Nancy Santesso Rick Ziehler* Abe Bornstein Holger Schunemann Tawana Wright Barney Eskin * Sharon Straus Louise Falzon Pat Gallagher TJ Jirasevijinda Eddy Lang* Barbara Lock* Stewart Wright* Pattie Mongelia Suzana Alves Silva* Judy Stribling* Stewart Wright*
TEACHING EVIDENCE ASSIMILATION FOR COLLABORATIVE HEALTHCARE
SPONSORSHIP
Funding for this conference is made possible [in part] by Grant No. 1R13HS018607-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercialpractices, or organizations imply endorsement by the U.S. Government.
TEACHING EVIDENCE ASSIMILATION FOR COLLABORATIVE HEALTHCARE
DISCLOSURES
No Financial Disclosures Declared
TEACHING EVIDENCE ASSIMILATION FOR COLLABORATIVE HEALTHCARE
TEACHING EVIDENCE ASSIMILATION
• GRADE: Health Care Recommendations
• Knowledge Translation
• Individualized Care
• Policy
• Adaptation/implementation
• Delivery
Background: Evidence-based Individualized Care
• SR of effectiveness of EBM teaching to post-graduates• 28 controlled studies; 5 involved integrated teaching• Behavior change assessed via self-report• Only integrated teaching affected skills, attitude or behavior• Validity of studies involving integrated teaching
challengeable• BOTTOM LINE: evidence nil that traditional approaches to
teaching evidence-based medicine affect behavior or patient care
Coomarasamy A, et al BMJ 2004;329:1017
Background: Evidence-based Individualized Care EBM Teaching at NYAM• Practice based approach• Emphasis on initiation skills• Pilot study 2004-2006: graduates
unable to derive a need for research evidence from a clinical encounter
Wyer P, et al Adv Health Sci Educ 2009;14:515
Background: Evidence-based Individualized Care What is Practice Based Learning?
• Stemmler Fund Project 2006-2008• Define and Assess Practice-Based Learning
and Improvement Cognitive Skills (ACGME)• Clinical action first, information literacy
second
Chatterji M, et al J Grad Med Educ 2009;1:287
Policy Adaptation, Implementation: The New Frontier• 2007 KT for EM Conference• Systems based care and clinical
evidence• Cross specialty, multidisciplinary
collaboration
Lang E, et al . Acad Emerg Med 2010;17:865
Dimensions of Evidence Based Care
• “Evidence Based Guidelines”• “Evidence Based Individual Decision Making”
Eddy D. Health Affairs 2005;24:9
The Bridge• The Wright model• Evidence-informed QI linked to
education• Multifaceted ED based care pathways in
designated clinical areas• Systematically drew on clinical evidence
Wright et al . Ann Emerg Med 2008;51:80
Active TEACH Projects• NYC: The Allen Hospital (Heart failure)• N Brunswick CA: St John’s Regional (Heart failure)• Grand Rapids: Spectrum Healch/U Michigan
– Y1 Imaging for TIA– Y2 Acute brain ischemia in rural affiliates
• St Lukes Health Care System-Kansas City– Avoid unnecessary catheterization– Pre-op MRSA screening
• NYC: Brooklyn Hospital (Sepsis)
Design for Synergy• Preparation-Plenary-Seminar-Small Group• Seminars
– Day 1: Track specific activity– Day 2: Cross track content sharing
• Day 3: Reportage