Decision Support:
Provide Continuous Skill-Oriented Interactive Training Programs for All Staff to Update Knowledge of Current Guidelines
- Evaluate the educational needs of staff.
- Schedule in-service training routinely. Include skill building in training, such as:
- Interpreting resistance test results
- Assessing patient education needs in the face of continued risk behaviors
- Assessing adherence
- Managing hepatitis B or C co-infection
- Managing hyperlipidemia
- Use an expert, mentor, or specialist for education.
- Consider using care management conferences to encourage guideline-based practice:
- Develop a multidisciplinary case review/care management team.
- Determine the frequency of case reviews.
- Decide how case review information will be used:
- To make changes in care delivery
- To educate providers
- To educate patients.
- Identify resources for obtaining emerging or updated information and ensure that staff have ready access.
- Keep surveys simple and easy to complete.
- Remember to include staff debriefing sessions (e.g., in training sessions).
- Remember the training needs of case management staff.
- Use multiple media for training (e.g., memos, "commercials" during in-service training).
- Make use of existing means of reaching staff.
- Use bulletin boards in staff areas or staff restrooms, and change them frequently.
- Consider pop quizzes.
- Make sure Continuing Medical Education (CME) credits are consistent with your care guidelines.
- Provide Continuing Education Unit credits for participation in the training.
- Provide certificates.
- Survey staff to assess comfort and confidence in making clinical decisions.
- Use the same specialist for referrals, consults, and education. Choose a person who believes in primary care as the basis for delivery of good care to patients with chronic disease.
- Invite experts to provide staff training, for example, hepatologists or gastroenterologists on hepatitis co-infection, obstetrician-gynecologists on HIV in pregnancy, pediatricians on HIV in adolescents, and psychiatrists and psychologists on depression and chemical dependency.
- Consider using peers to educate.
- Keep meetings brief and purposeful.
- Use lessons from individual patients for teaching population-based principles.
- Include "next steps" as part of the agenda.
- Periodically review the effectiveness of the care management conference process. Do not allow it to become a time drain.
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