Provider adherence to COPD guidelines: Relationship to organizational factors

Marcia M. Ward, Jon W. Yankey, Thomas E. Vaughn, Bonnie J. BootsMiller, Stephen D. Flach, Shea Watrin, Bradley Doebbeling

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Rationale, aims and objectives: A clinical practice guideline for chronic obstructive pulmonary disease (COPD) was implemented in all Veterans Health Administration (VHA) hospitals in the US. The aim of the current analyses is to describe current adherence rates and the organizational factors related to provider adherence to the COPD guideline. Methods: We administered a survey to key informants that assessed adherence to the COPD guideline, approaches to disseminating and implementing the COPD guideline, providers' views of the COPD guideline and guidelines in general, and attitudes about the organizational climate. Results: Surveys were returned by 242 key informants (58%) at 130 of the 143 VHA hospitals (91%). Adherence to the COPD clinical practice guideline is perceived by quality managers within the VHA to be good. The final multivariable predictor model identified five measures that were related to provider adherence with the COPD guideline (R 2 = 0.43): responsibilities were changed to support adherence to the COPD guideline, physicians believe that guidelines implemented in the past year were applicable to their practice, patient care providers consistently participate in activities to improve the quality of care, the regional network office monitors the pace at which guidelines are implemented, and there is a system to provide feedback on routinely collected guideline adherence data collected in addition to External Peer Review Program data. Conclusions: Organizations can play an important role in providing a supportive climate to facilitate their providers' adherence to guidelines by implementing processes and culture changes that involve these five measures.

Original languageEnglish (US)
Pages (from-to)379-387
Number of pages9
JournalJournal of Evaluation in Clinical Practice
Volume11
Issue number4
DOIs
StatePublished - Aug 2005
Externally publishedYes

Fingerprint

Chronic Obstructive Pulmonary Disease
Guidelines
Veterans Health
United States Department of Veterans Affairs
Guideline Adherence
Practice Guidelines
Peer Review
Quality of Health Care
Patient Care
Organizations
Physicians

Keywords

  • Adherence
  • COPD
  • Guideline
  • Organizational factors
  • Physician practices

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Information Management
  • Nursing(all)

Cite this

Provider adherence to COPD guidelines : Relationship to organizational factors. / Ward, Marcia M.; Yankey, Jon W.; Vaughn, Thomas E.; BootsMiller, Bonnie J.; Flach, Stephen D.; Watrin, Shea; Doebbeling, Bradley.

In: Journal of Evaluation in Clinical Practice, Vol. 11, No. 4, 08.2005, p. 379-387.

Research output: Contribution to journalArticle

Ward, Marcia M. ; Yankey, Jon W. ; Vaughn, Thomas E. ; BootsMiller, Bonnie J. ; Flach, Stephen D. ; Watrin, Shea ; Doebbeling, Bradley. / Provider adherence to COPD guidelines : Relationship to organizational factors. In: Journal of Evaluation in Clinical Practice. 2005 ; Vol. 11, No. 4. pp. 379-387.
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