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Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative.
Acad Emerg Med 2007; 14(11):949-54AE

Abstract

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.

Authors+Show Affiliations

Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17967956

Citation

Blomkalns, Andra L., et al. "Guideline Implementation Research: Exploring the Gap Between Evidence and Practice in the CRUSADE Quality Improvement Initiative." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 14, no. 11, 2007, pp. 949-54.
Blomkalns AL, Roe MT, Peterson ED, et al. Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative. Acad Emerg Med. 2007;14(11):949-54.
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. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 14(11), pp. 949-54.
Blomkalns AL, et al. Guideline Implementation Research: Exploring the Gap Between Evidence and Practice in the CRUSADE Quality Improvement Initiative. Acad Emerg Med. 2007;14(11):949-54. PubMed PMID: 17967956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Guideline implementation research: exploring the gap between evidence and practice in the CRUSADE Quality Improvement Initiative. AU - Blomkalns,Andra L, AU - Roe,Matthew T, AU - Peterson,Eric D, AU - Ohman,E Magnus, AU - Fraulo,Elizabeth S, AU - Gibler,W Brian, PY - 2007/10/31/pubmed PY - 2007/12/13/medline PY - 2007/10/31/entrez SP - 949 EP - 54 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 14 IS - 11 N2 - 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. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/17967956/Guideline_implementation_research:_exploring_the_gap_between_evidence_and_practice_in_the_CRUSADE_Quality_Improvement_Initiative_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1069-6563&date=2007&volume=14&issue=11&spage=949 DB - PRIME DP - Unbound Medicine ER -