Sosa-Garca JO, Martnez-Aldana M, Puentes-Rosas E, Pineda-Prez D, - - PowerPoint PPT Presentation

Sosa-García JO, Martínez-Aldana M, Puentes-Rosas E, Pineda-Pérez D, Hernández-Santillán D

Background

• The Clinical Practice Guidelines (CPGs) developed by

National Health System (NHS) in Mexico aim to improve:

– The quality of health system – Reduce the heterogeneity of health care – Make more efficient use of resources.

• The CPGs are related to medical practice and help to

decrease its variability, standardizing the attention process and helping doctors to take the best clinical decisions.

• The CPGs diffusion takes place through online Master

Catalog (MC).

Aim

Evaluate the success of CPGs diffusion and implementation in the medical centers of the NHS in Mexico

Methods

480 health centers were randomly sampled (IMSS, ISSSTE, SESA), 400 primary level care and 80 second level care The evaluation was conducted by an external consultant and physicians trained

• Doctors answered a questionary to establish their

knowledge, training and perception of the CPGs;

• Diffusion and implementation staff also replied another

questionary and clinical records were checked to confirm the CPGs use. At each one of the centers was verified the CPGs existence:

Results Distribution of CPGs

The CPGs diffusion takes place through

• nline MC.

80% refer to have the MC of CPGs. 1 of every 2 diffusion personnel states to have printed CPGs. The global level of training in CPGs was 56%.

88% 36% 81% 92% 70% 40%

Knowledge of the CPGs Knowledge of some other guideline Consultation of some CPG in the last month Availability of the CPGs Access to MC Knowledge of web site address of MC

INDICATOR PERCENTAGE

Results

Knowledge of CPGs

Results

Knowledge of CPGs

• The knowledge that the CPGs made by NHS are available was of 88%.
• Eight of every ten interviewed doctors who know the CPGs stated

having consulted them during the last month.

• The 92% of the doctors who know CPGs declared that at their centers

these tools are available.

88% 36% 81% 92% 70% 40%

Knowledge of the CPGs Knowledge of some other guideline Consultation of some CPG in the last month Availability of the CPGs Access to MC Knowledge of web site address of MC

INDICATOR PERCENTAGE

Results

Perception of CPGs

75% 78% 95% 97% 97% 97% Consider that CPGs should be

• bligatory

Consider practical the format of CPGs Consider that the recommendations should be standardized Consider that CPGs improve attention quality Consider that CPGs support clinical decisions Consider that should be diffused since starting the professional formation

PERCENTAGE

INDICATOR

Results

Diffusion and implementation

Results

Diffusion and implementation

Lack of physical equipment and material Lack of trained personnel to diffuse Excess of work/lack of time Small confidence in the utility of the CPGs Indisposed personnel to the use of the CPGs Other Inertia of the previous practice Excess of work/lack of time Disagreement with the concept of the CPGs Lack of physical equipment and material Indisposed personnel to the use of the CPGs Other

BARRIERS FOR IMPLEMENTATION BARRIERS TO DIFFUSE

Limits

Failed to get the required information

Five units Lack clinical record

Incomplete interview

Understaff

Incomplete checklist

Lack of time

Bottom line

The distribution of CPGs in health units is good. The knowledge and perception of CPGs by health professional are acceptable. The processes of the diffusion and implementation of the CPGs vary according to the level of care, however, further work is needed in the implementation of these tools.

CENETEC-SALUD

THANKS

cenetec@salud.gob.mx www.cenetec.salud.gob.mx

Cenetec-Salud @cenetec