Prioritizing evidence-based practices for acute respiratory distress syndrome using digital data: an iterative...

Area of Science:

• Critical Care Medicine
• Health Services Research
• Clinical Practice Guidelines

Background:

• Evidence-based practices (EBPs) for invasive mechanical ventilation differ in evidence quality and implementation feasibility.
• Prioritizing EBPs is crucial for guiding clinical decisions and focusing implementation efforts to enhance patient care.

Purpose of the Study:

• To develop and describe a rapid method for prioritizing EBPs in invasive mechanical ventilation.
• To identify EBPs associated with reduced mortality and/or shorter ventilation duration for patients with acute respiratory failure or acute respiratory distress syndrome.

Main Methods:

• A 4-step rapid method was employed, involving EBP identification, rating using the Guideline Implementability Appraisal (GLIA) tool, clinician surveys, and metric development.
• Steps 2 and 3, focusing on GLIA ratings and clinician assessments of 11 prioritized EBPs from an initial list of 30, are detailed.

Main Results:

• Eleven EBPs were prioritized from 30, based on ratings and surveys from clinician researchers.
• Forty-two clinicians across 8 hospital systems assessed these 11 EBPs, providing data for metric development.

Conclusions:

• The developed prioritization process successfully identified 11 key EBPs for optimizing invasive mechanical ventilation.
• This adaptable method can guide clinicians in improving outcomes for critically ill patients and can be applied to other healthcare contexts.