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070 Strategies for Health System Implementation of Guidelines on Overweight and Obesity
  1. Y Abrahamian,
  2. H Watson
  1. Kaiser Permanente, Southern California Permanente Medical Group, Pasadena, USA


Background Evidence-based clinical practice guidelines (CPGs) for adult obesity and overweight provide recommendations to clinicians on interventions for weight loss and maintenance. organisation-wide implementation of these guidelines is critical to achieve changes in practice and patient health outcomes.

Context To describe novel guideline implementation strategies used by a large US health care organisation to improve the care of obese and overweight adults.

Description of Best Practice An evidence-based CPG was developed to address management strategies for a rapidly increasing number of obese and overweight patients. Interventions aimed at practitioner, patient and systems levels were tailored to facilitate implementation of CPG recommendations. Practitioner interventions included basic knowledge dissemination via electronic distribution of CPGs, presentation of CPGs at clinician champions’ meetings; and development of point-of-care job aids, such as in-clinic access to online CPGs and office prompts to refer obese patients to weight management classes. Patient-level interventions included proactive outreach for health education classes and telephone-based coaching; point-of-care educational publications; and after-visit summaries with weight management recommendations. Interventions at the systems level included proactive office encounter recording of patient BMI and exercise regimen; clinical performance goals; reporting of health outcomes of participants in weight management programmes; and, a physician continuing medical education (CME) course. Continued improvements in clinician/patient communication about weight, collection of patient weight information, and patient health outcomes have been observed.

Lessons for Guideline Developers, Adaptors, Implementers, and/or Users Novel approaches to integrating guidance on the management of obesity and overweight into practice can achieve significant changes in clinical practice and patient health outcomes.

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