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The implementation of clinical guidelines in a managed care setting: implications for children with special health
S J Rolnick1, S K Flores, A M O'Fallon
1HealthPartners Research Foundation, Minneapolis, Minnesota, USA.
Overview:
The project tracked the development and implementation of a pediatric asthma guideline to determine its usefulness as a quality assurance mechanism for children with special health care needs.
Methods:
Interviews were conducted with clinic staff to gather descriptive information about guideline implementation at owned clinics within a large HMO.
Results:
Providers developed multiple implementation strategies emphasizing patient/family education. Service coordination within the health plan was well established, while coordination of services beyond the health plan was less clearly related to guideline implementation.
Conclusion:
Guideline implementation appeared to be a highly variable process. Clinical guidelines alone may not be sufficient tools of quality assurance for children with chronic or complex conditions.