Abstract
This study examined whether emergency physicians (EPs) exposed to multiple dissemination
strategies for the Ottawa Ankle Rules (OARs) would reduce extremity radiography use.
We conducted a prospective cohort study comparing intervention (n = 2) with control
(n = 2) hospitals over a 2-year period. All EPs received the paper-based rules during
the run-in phase; EPs in the intervention hospitals were also subjected in sequence
to valid dissemination approaches. Provincewide dissemination of the OARs did not
decrease radiography during the run-in period (92% vs. 93%; P = .36). Sequential directed education and personalized feedback strategies failed
to reduce radiographic ordering rates (P = .54) or the ordering of both foot and ankle radiographs (P = .11) over time. The use of radiography did not decrease despite the use of a variety
of dissemination strategies. Additional research is required to determine the most
effective methods of incorporating guidelines into emergency practice.
Keywords
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Article Info
Publication History
Accepted:
April 22,
2003
Received:
March 30,
2003
Footnotes
☆Supported by the Capital Health Authority, Alberta Medical Association (AMA) Clinical Practice Guideline Program, and the AMA-Medical Services Branch Grant Program. Dr Rowe is supported by the Canadian Institute of Health Research (CIHR; Ottawa, Ontario) as a Canada Research Chair.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
