Haven, E (Emile) van der (2012) Naleving van de Zwolse Werkafspraak Radiologie en het effect van de Interline cursus : Barrières voor huisartsen bij het volgen van Zwolse werkafspraken. thesis, Medicine.
Full text available on request.Abstract
Background: The policy between general practitioners (GP’s) and medical specialists in the area of Zwolle has been defined in collaborative guidelines (Zwolse Werkafspraken). The guideline “Radiological investigations” has been updated recently. Every GP in the area received the updated guideline. This guideline is further discussed during an interactive small group course (Interline cursus). Objectives: In this study we explored if attending the course improved adherence to the guideline. In addition to this we identified barriers which are perceived by GP’s following the recommendation to not order a plain x-ray for patients with suspected sinusitis. Methods: We used the number of ordered plain sinus x-rays to monitor the adherence to the guideline. The GP’s who attended the course (n=25) and a control group (n=100) were included. We analysed the number of ordered sinus x-rays during the months November 2011 through February 2012 and compared this to the same period a year prior to the course. In addition to this a questionnaire about the guideline, the recommendation and the experienced barriers following the recommendation was conducted and has been completed by 77 GP’s. Results: Both the intervention and control group ordered less sinus x-rays in the period after the course in accordance with the recommendation. Comparing the groups with each other did not show any significant differences for either of the periods. However, there seemed to be a tendency that the intervention group ordered less sinus x-rays than the control group after the course. The results of the questionnaire showed that the intervention group was more aware of the guideline content. Besides lack of knowledge, we identified two other important barriers to adherence. These barriers were: “non congruence of the recommendation with patient wishes and preferences” and “the lack of applicability to the individual patient”. Conclusion: The course seems to be an effective intervention for the knowledge related barriers. For the other barriers identified other types of interventions are required, for example patient mediated interventions. Extension of the period in which the number of ordered plain sinus x-rays is researched and future research on other collaborative guidelines will provide more information about the effectiveness of the course (Interline cursus).
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair Begeleider: and Nijholt, dr. I.M. |
| Supervisor name: | Extern Begeleider: and Prenger, drs. B. and Locatie: Isala Klinieken te Zwolle in samenwerking met MCC K |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:02 |
| Last Modified: | 25 Jun 2020 11:02 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2218 |
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