NB. Volkova, CC. Fletcher, RW. Tevendale, SM. Munyaradzi, S. Elliot and MW. Peterson (2008). Impact of a multidisciplinary approach to guideline implementation in diabetic ketoacidosis. American journal of medical quality : the official journal of the American College of Medical Quality, 23(1), 47-55. https://doi.org/10.1177/1062860607311015

PubMed 18187590

[Abstract]
Background. Faculty members developed diabetic ketoacidosis (DKA) guidelines based on the current American Diabetes Association guidelines. Objectives. To evaluate the impact of a multidisciplinary approach to implementing DKA guidelines on residents' knowledge, guideline compliance, and patient outcomes. Design. Longitudinal case-control study with 2 arms. Setting. University-affiliated teaching hospital in Fresno, California. Methods. A Web-based testing software (TestWare) was used for educational/ assessment testing before and after DKA guidelines implementation. Patients' charts were reviewed to determine the degree of guideline compliance, patient care charges, and length of stay before and after DKA guidelines introduction. Results. Testing scores improved from 48% to 54% correct answers after implementation of the guidelines (P = .06). Overall, guidelines compliance improved from 67% to 88% (P < .05). Conclusion. A multidisciplinary intervention including knowledge assessment, individualized education, and formal didactic teaching was effective at improving knowledge and guideline compliance in DKA for internal medicine residents.