Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The importance of organizational characteristics for improving outcomes in patients with chronic disease: a systematic review of congestive heart failure | Leykum et al. Implementation Science 2010 5 66 http content 5 1 66 Implementation Science IMPLEMENTATION SCIENCE SYSTEMATIC REVIEW Open Access The importance of organizational characteristics for improving outcomes in patients with chronic disease a systematic review of congestive heart failure 1 2 1 11 3 Luci K Leykum Michael Parchman Jacqueline Pugh Valerie Lawrence Polly H Noel Reuben R McDaniel Jr Abstract Background Despite applications of models of care and organizational or system-level interventions to improve patient outcomes for chronic disease consistent improvements have not been achieved. This may reflect a mismatch between the interventions and the nature of the settings in which they are attempted. The application of complex adaptive systems CAS framework to understand clinical systems and inform efforts to improve them may lead to more successful interventions. We performed a systematic review of interventions to improve outcomes of patients with congestive heart failure CHF to examine whether interventions consistent with CAS are more likely to be effective. We then examine differences between interventions that are most effective for improving outcomes for patients with CHF versus previously published data for type 2 diabetes to explore the potential impact of the nature of the disease on the types of interventions that are more likely to be effective. Methods We conducted a systematic review of the literature between 1998 and 2008 of organizational interventions to improve care of patients with CHF. Two independent reviewers independently assessed studies that met inclusion criteria to determine whether each reported intervention reflected one or more CAS characteristics. The effectiveness of interventions was rated as either 0 no effect mixed effect or effective based on the type number and significance of reported outcomes. Fisher s exact test was used to examine the association between CAS characteristics
