3rd Place
Facilitating VA Clinical Practice Guideline Implementation
via On-Line Communities of Practice – The COLLAGE Project*
Frances Park Matt, PhD
VERDICT/South Texas Veterans Healthcare System
Audie L. Murphy Division
Problem:
Systematic reviews indicate availability of clinical practice guideline (CPG) information does not automatically change practice. (Lomas et al. 1989; Greco & Eisenberg, 1993)
Evidence:
A knowledge dissemination and implementation vehicle with persuasive pull-capacity to stimulate change at the microsystem level may overcome CPG diffusion and practice adoption barriers.
Strategy:
Communities of practice (CoP) offer a social structure for managing knowledge and developing a common practice. An on-line, interactive web-space (“COLLAGE”) dedicated to the growth of virtual CoP’s may offer potential pull-capacity.
Practice Change:
The COLLAGE Project seeks evidence of increased knowledge dissemination and uptake across geographically dispersed VHA employees.
Evaluation:
Indices of COLLAGE effectiveness: nature/volume of web-site traffic, number/identity of posted and accessed documents.
Results:
2003 evidenced: seven-fold increase in number of COLLAGE users, four-fold increase in pages viewed, a five-fold increase in website hits: Most accessed resources were guideline materials and library resources. Customization of CoP Homepages equates to increased demand for more complex communication tools.
Recommendations:
On-line CoPs can facilitate knowledge dissemination; CoP leadership must demonstrate interest and commitment to encourage community. Value of knowledge derived from accessing web-space must exceed pay-off from offered from competing time demands.
*A Veterans Health Administration Health Services Research & Development (VHA HRSR) grant funded research project.
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