Not of one mind: mental models of clinical practice guidelines in the Veterans Health Administration.

Objective: The purpose of this paper is to present differences in mental models of clinical practice guidelines (CPGs) among 15 Veterans Health Administration (VHA) facilities throughout the United States.Data Sources: Two hundred and forty-four employees from 15 different VHA facilities across four...

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Publicado en:Health Services Research Vol. 40; no. 3; pp. 829 - 848
Autores principales: Hysong SJ, Best RG, Pugh JA, Moore FI, Hysong, Sylvia J, Best, Richard G, Pugh, Jacqueline A, Moore, Frank I
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2005
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1475-6773.2005.00387.x
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        atl: Not of one mind: mental models of clinical practice guidelines in the Veterans Health Administration.
      aug:
        au:
          Hysong SJ
          Best RG
          Pugh JA
          Moore FI
          Hysong, Sylvia J
          Best, Richard G
          Pugh, Jacqueline A
          Moore, Frank I
        affil: ALMD/South Texas Veterans Health Care System, 7400 Merton Minter Blvd. Ambulatory Care 11C6, San Antonio, TX 78229-4404, USA
      sug:
        subj:
          Attitude of Health Personnel
          Practice Guidelines
          Professional Compliance
          Feedback
          Grounded Theory
          Hospitals, Veterans
          Mental Processes
          Organizational Compliance
          Organizational Culture
          Psychological Theory
          Purposive Sample
          Qualitative Studies
          Quality Assurance
          Semi-Structured Interview
          Thematic Analysis
          Funding Source
          Human
      ab: Objective: The purpose of this paper is to present differences in mental models of clinical practice guidelines (CPGs) among 15 Veterans Health Administration (VHA) facilities throughout the United States.Data Sources: Two hundred and forty-four employees from 15 different VHA facilities across four service networks around the country were invited to participate. Participants were selected from different levels throughout each service setting from primary care personnel to facility leadership.Study Design: This qualitative study used purposive sampling, a semistructured interview process for data collection, and grounded theory techniques for analysis.Data Collection: A semistructured interview was used to collect information on participants' mental models of CPGs, as well as implementation strategies and barriers in their facility.Findings: Analysis of these interviews using grounded theory techniques indicated that there was wide variability in employees' mental models of CPGs. Findings also indicated that high-performing facilities exhibited both (a) a clear, focused shared mental model of guidelines and (b) a tendency to use performance feedback as a learning opportunity, thus suggesting that a shared mental model is a necessary but not sufficient step toward successful guideline implementation.Conclusions: We conclude that a clear shared mental model of guidelines, in combination with a learning orientation toward feedback are important components for successful guideline implementation and improved quality of care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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