Catherine Yu*, St. Michael's Hospital, University of Toronto, Toronto, Canada Susie Jin, Pharmacy 101, Cobourg, Canada Lori Berard, University of Manitoba, Winnipeg, Canada Maureen Clement, University of British Columbia, Kelowna, Canada Calvin Ke*, University of British Columbia, Vancouver, Canada Peter J Lin, Canadian Heart Researc Centre, Toronto, Canada Sharon E Straus, St. Michael's Hospital, University of Toronto, Toronto, Canada Carolyn Gall-Casey, Canadian Diabetes Association, Toronto, Canada Track: Practice Presentation Topic: Web 2.0 approaches for clinical practice, clinical research, quality monitoring Presentation Type: Oral presentation Submission Type: Single Presentation Building: Sheraton Maui Resort Room: B - Kapalua Date: 2014-11-14 02:50 PM – 03:35 PM Last modified: 2014-09-04

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Background: The Canadian Diabetes Association 2013 Clinical Practice Guidelines are an evidence-based synthesis of relevant literature comprehensively addressing diabetes care. Our aim is to successfully disseminate and implement the Guidelines to improve the quality of diabetes care. One of our strategies to fulfil this aim was the development, launch and implementation of a web-portal (guidelines.diabetes.ca).

Methods: We used the Knowledge to Action (KTA) framework to build our dissemination strategy by 1) identifying the problem and selecting knowledge; 2) adapting knowledge to local context; 3) assessing barriers and facilitators to knowledge use; 4) selecting tailoring and implementing interventions; 5) monitoring knowledge use; 6) evaluating outcomes; 7) sustaining knowledge use.

Results: Based on a literature review and a national online survey of dietitians, nurses, pharmacists, family physicians, nurse practitioners and internists, we selected 6 key areas: screening/diagnosis, glucose-lowering, vascular protection, team care/organization of care, self-management, and individualization of care. We identified barriers to guideline uptake, preferred and effective strategies for dissemination. As a result, our patient- and provider-directed strategy aims to not only provide knowledge, but to promote team-based care and self-management centred around the individual. It consists of electronic point of care tools, electronic medical record templates, laboratory prompts and a communications campaign, complemented by minimal hard copy resources. Electronic tools (available at guidelines.diabetes.ca) include interactive decision-support algorithms, flowsheets, reference guide, communication logs, patient resources. Knowledge use is monitored through website usage statistics, documentation of guideline-related activities (eg workshops) and individual interviews with target user population; we will report on preliminary website usage statistics, including prevalence of use, most frequently used tools, patterns of tool use, site penetration, geographic distribution, and time trends.

Conclusions: For guidelines to have an impact on patients, they must be effectively integrated into clinical care. In this digital era, this necessitates electronic point of care tools, usable and immediately accessible information resources, and a recognized web presence. The KTA framework, which necessitates stakeholder engagement and iterative design, provides a systematic approach to attaining this goal.