Evidence Based Health Care Quality Help: Delfini Tools

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*Delfini* LIBRARY Below is a selection of tools and educational materials created by Delfini. Our site makes available other resources as well from the work of others and other work we have done including clinical guidelines, systematic reviews, evidence-based commentaries, case studies and more. See Resources.
CODES F Delfini Favorite or Frequently Used Item N New Tool U Newly Updated Since Last DelfiniGram™ IMPORTANT: Because we are continually refining our tools, we recommend that you download tools just-in-time rather than storing them on your own computer to ensure you are getting our best version.
Page Navigation Utility Tools Critical Appraisal Tools Critical Appraisal Primers/Papers EB Committee Tools Quality Improvement Project Tools Patient Communication Tools EBM Organization Help Other Miscellaneous Tools
Possibly Our Most Important Reading
Delfini Fact Sheet: Quality of Care, Quality of Science & Importance of Critical Appraisal Skills Why we are doing this work; why critical appraisal matters...
Utility Tools
EBM Glossary Online Searching the Medical Literature Tool [WORD] Others available at Delfini Web Links
Critical Appraisal Tools
Topic	Code	Item	How We Use Them	Get
CRITICAL APPRAISAL Primary Studies : Short Tools Efficacy of therapies in superiority trials; some with notes and considerations for other circumstances	F	1-Pager Pearls: Basics of Evaluating Evidence in Superiority Trials for Therapies New & Updated 07/22/2010	Novice/ Intermediate teaching tool, self-study guide, reminder tool	[WORD] [PDF]
	F	1-Pager Quick Checklist for Efficacy of Therapeutic Interventions (with supplemental questions for diagnostic testing and screening)	All levels for reviewing with articles	[WORD]
		1-Pager Pearls: Reminders for Validity Detectives for Critical Appraisal for Efficacy of Therapies	Novice process key points	[WORD]
CRITICAL APPRAISAL Primary Studies : Comprehensive Tool	F U	~14 Pages Primary Studies: Long Tool Short EBM "Textbook"	Explains concepts in the short tools and more; teaching tool, self-study guide	[WORD]
: Diagnostic Testing	F N	1-Pager Pearls: Diagnostic Testing	Considerations	[WORD]
: Diagnostic Testing	N	Diagnostic Testing Calculator	For calculating measures of test function and getting results in natural English	[Excel]
: Screening	N	1-Pager Screening	Considerations	[WORD]
: Oncology	F	1-Pager Chart of Oncology Outcomes	Chart of issues with various outcomes	[PDF]
RESULTS ASSESSMENT	F N	1-Pager Analyzing Results IMPORTANT: Includes information on assessing confidence intervals (also see Primers) New & Updated 07/27/2010	Tips on assessing results and determining meaningful clinical benefit	[WORD]
	N	1-Pager Composite Endpoints	Considerations	[WORD]
	F N	1-Pager Intention-to-Treat (ITT) Analysis New & Updated 07/29/2010	Considerations	[WORD]
		ITT Recalculation Spreadsheet	Aids with assignng missing values and re-computing p-value	[Excel]
	F N	1-Pager Time-Event-Analysis New & Updated 07/27/2010	Considerations	[WORD]
	N	1-Pager Comparative Directions (Equivalence and Non-inferiority Trials) (see also Primers) New & Updated 07/27/2010	Considerations for non-inferiority and equivalence trials	[WORD]
SAFETY	N	1-Pager Pearls: Safety New & Updated 07/22/2010	Considerations	[WORD]
CRITICAL APPRAISAL Secondary Studies : Comprehensive Tool	F	~10 Pager Systematic Review Tool	Principal tool for appraising secondary studies; teaching tool, self-study guide	[WORD]
CRITICAL APPRAISAL Secondary Sources : Comprehensive Tool	F	~10 Pager QI Project Appraisal Tool Secondary Sources reference primary and secondary studies (e.g., clinical guidelines, disease management protocols, pathways, etc.)	Principal tool for appraising secondary sources; teaching tool, self-study guide	[WORD]
CRITICAL APPRAISAL Economic Studies : Comprehensive Tool	F	~10 Pager Healthcare Economic Study Review Tool	Principal tool for appraising any economic studies such as cost-effectiveness analyses and pharmacoeconomic studies; teaching tool, self-study guide	[WORD]
CONCLUDING & SUMMARIZING	F	Grading, Wording Conclusions and Results Table Tool	Principal tool for advise on grading and wording; results table tool is a cut-and-paste utility	[WORD]
		Ideal Study Parameters	Preparation for scientific review	[WORD]
		Evidence Synthesis Tool	Tips for combining results from multiple studies	[WORD]
		Qualitative Systematic Review Template	Master document for assembling a scientific review and report generation	Programs
DOCUMENTATION : Primary Studies		Study Summary & Critique	For online documentation for project work	[WORD]
		Mini-online application version	For online documentation for project work	[WORD]
	U	Search Documentation	For online documentation for project work	[WORD]
Critical Appraisal Primers & White Papers
Evidence Essentials web page for information on a variety of important topics Online
Study Design Issues		Case Series	Problems with	[PDF]
	F	Observations for Interventions	General weaknesses of observations	[PDF]
		Problems with Narrative Reviews	Problems with	[PDF]
Various Topics		Comparative Directions (See also Critical Appraisal 1-Pager)	General issues and considerations	[PDF]
		Attrition Bias	Problems with	[PDF]
		Missingness	White paper on issues	[PDF]
	F N	How to Read a Forest Plot	Teaching aid, self-study guide	[PDF]
	F	Confidence Intervals & Their Use for Interpreting Significance of Results	Teaching aid, self-study guide	[PDF]
Evidence-based Committee Help
General		EBM Committee Tips Tool	General operational suggestions	[WORD]
Formulary Management : Comprehensive	F	Committee Deliberations Tool & EBM Pharmacy & Therapeutics Committee Tips Tool	Sequential steps and detailed tips for effective committee functioning and decision-making	Programs
Formulary Management Publications		Formulary Publication Page Evidence-based Pharmacotherapy Publication Page California Pharmacist Publication Page	Monograph and systematic review preparation help	Online at links to the left
Medical Technology Assessment : Comprehensive		EBM Medical Technology Assessment Committee Tips Tool	Sequential steps and detailed tips for effective committee functioning and decision-making	Programs
Quality Improvement Project Mangement Help
EB QI Model		Evidence-based Value Model for Clinical Quality Improvement	Beyond process improvement, a model for EBQI	Online mini version
The EB QI Team & the EB QI Project : Comprehensive	F	Suggestions for Evidence-based Quality Improvement Teams: Conducting Projects	Sequential steps and detailed tips for creating and managing EB-QI teams and projects	[WORD]
Project Development		Project Proposal Tool	Considerations	[WORD]
Impact Assessment		Project Change Assessment Tool	Key considerations in addition to cost	[WORD]
Implementation	F	Project Implementation Strategies and Tool	Strategies for creating behavior change and implementing projects	[WORD]
Measurement : Primer	F	2-Pager Quality Measurement Efforts	Teaching aid, self-study guide	[PDF]
Performance Measurement : Comprehensive		Performance Measures (including selecting good projects) See also Delfini Publication Page: Performance Measurement	Sequential steps and detailed tips for development, implementation, reporting and more	[WORD]
Performance Measurement : Primer		Performance Measures — Quick Tips Checklist	Teaching aid, self-study guide	[Online]
Cost Analysis Help		See Critical Appraisal Tools for "Healthcare Economic Study Review Tool"
Evidence Outcomes into Cost		NNT Comparison Calculator	A spreadsheet calculator to do NNT conversions for cost analysis	[Excel]
More Cost Analysis Tools & Ideas Electronic Spreadsheet Templates & Approaches (for ideas only!) Example for projecting impacts of change - Hypothetical Venous Ulcer Project [PDF] & [Excel] (There is no guarantee on the formulas, utility or anything else — you will need to examine closely and apply your own Excel skills and common sense to use!) & Approaches (example online at On The Same Page™ - *Flowing Evidence into Cost Analysis:* Powerful Ways with NNT) IBS Example — Impact Assessment Template & Sample: Spreadsheet template included as an optional, customizable aid designed to help health care organizations project potential changes which may result from successful guideline implementation. A completed tool is included as an example and was constructed using assumptions generated through meetings with national medical leaders. Overwrite these assumptions to reflect your own along with your local conditions. Use to perform sensitivity analyses. Useful, when modified, for other clinical improvement projects. Click here to download the sample tool — Impact Assessment Template [Excel]
Patient Tools for Healthcare Providers (& One for Patients)
Information Development Help		Patient Information & Decision Aids Tool	Considerations for patient communication tools	[WORD]
Decision Support Help	F	Rx Messaging Scripts Template (Messaging script examples are available online.)	Treatment messaging & decision support tools for specific clinical topics	[WORD]
Engagement Help	F	GLIDE Patient Information & Engagement Encounter Map Greet Listen Inquire & Exchange Information Determine & Decide End	Communication tool for physicians and others who directly engage with patients to provide information, decision and action-oriented information during clinical encounters	[PDF] & [WORD]
General Help		*On the Same* Page** ™ — for Practitioner/Patient Information & Decision Aids	A variety of patient-centered readings, examples and help	Online at links to the left
For Consumers		Consumer Tips To Aid in Evaluating Health Care Quality	For patients	[WORD]
General Help for the Evidence-based Organization
The EBM Organization	F	Health Care Quality System Assessment Tool	Tool for assessing how prepared organizations are to apply an evidence-based quality approach; requirements	[WORD]
The EBM Organization		EBM Organizational Readiness Tool	Tool for helping health systems organize for an evidence-based approach	[WORD]
EBM Organization Publications		American College of Physician Executives publication page: The EBM Organization 3-part series	General information	Online at links to the left
ROI		The Return-on-Investment for EBM	Case studies and stories	[online]
Miscellaneous Other Tools
*Delfini* Law & Medicine Tool Checklist for Evaluating the Evidence-based Medicine Approach of Medical “Experts” [WORD] *Delfini* Meeting & Office Management Tools (see above in various sections for EBM Committee tools) Effective & Efficient Meetings [WORD] Agenda Builder (no instructions provided and requires knowledge of Excel) [Excel] Webinar Tips [WORD]