Long-Term Care Academic Detailing Service
What Providers Said
Academic Detailing, sometimes referred to as Educational Outreach, offers one on one visits with providers to discuss different clinical topic areas. Our Academic Detailing Service entails service-oriented and one-on-one visits focused on delivering providers with objective, balanced, evidence-informed information on best practices to optimize clinical care. This information is always tailored to each provider’s expressed needs and is delivered at a time that is convenient for them.
The Centre for Effective Practice (CEP) offered its Academic Detailing Service to support appropriate prescribing in Long-Term Care (LTC). It was offered to 41 LTC homes from September 2015 to March 2017. Two clinical topics were offered to LTC homes over this period. Funding was provided by the Province of Ontario through its Appropriate Prescribing Demonstration Project.
The first clinical topic focused on drug therapy decision-making related to antipsychotic prescribing for residents with behavioural and psychological symptoms of dementia.
Providers need an accurate, ongoing source of current data about the comparative effectiveness, safety and costs of treatments. This information can be time consuming to assemble from a continuous influx of research literature. By combining an interactive outreach approach with best evidence and experience, our Academic Detailers can meet the individual needs of providers and their teams. Academic Detailing programs continue to demonstrate positive impact on outcomes including appropriate prescribing, quality care, provider knowledge and provider satisfaction.
There are provincial programs running in British Columbia, Saskatchewan and Nova Scotia with past programs in both Alberta and Manitoba. Australia has a National Prescribing Service that includes 150 detailers working to support primary care providers. Programs are also running in over five US states. CEP led Ontario’s first Academic Detailing pilot project in 2007/2008 aimed at primary care providers on the topic of Type II Diabetes Management.
An Academic Detailing visit is about understanding your needs at the time of the visit, what aspects of the topic area are important to you, what questions you may have on recent evidence or resources/tools available to support you as you care for your residents. An Academic Detailer’s role does not include consulting or providing care to residents at your home or in your practice. They are an independent resource for you.
More specifically, during a visit, our Academic Detailer meets with long-term care home providers to discuss objective, balanced, evidence-informed drug information on best prescribing practices, based on the provider’s expressed needs. This information is delivered at a location and time that is convenient for the provider. Through each visit, Academic Detailers also equip providers with tools to support clinical decision-making, as well as material to share with residents’ families and caregivers. Group visits with the Academic Detailer will also be offered to support other members of the care team in areas of relevance to them.
Throughout the Academic Detailing service duration, CEP engaged over 770 LTC providers and staff from the participating 41 LTC homes. Overall, participating LTC providers and staff overwhelmingly reported a high level of satisfaction with the academic detailing service. The service encouraged providers to appropriately prescribe antipsychotics and review medication to prevent falls, increased provider confidence to incorporate best practices, and increased team communication. The CEP feels that academic detailing as an intervention has the potential to enhance patient/resident care and outcomes in the Ontario health care sector.
Our long-term care academic detailing service was part of the Appropriate Prescribing Demonstration Project.
The Appropriate Prescribing Demonstration Project was delivered on a provision of the 2012 Ontario Physicians Services Agreement to improve prescribing through voluntary, quality-based educational strategies that respected the confidentiality of provider practice data. This initiative evaluated the benefits of providing an array of educational supports related to appropriate prescribing in long-term care (LTC) homes. Educational supports included:
1. Focused visits between an Academic Detailer and provider. This service involved medication education that provided objective, balanced, evidence-informed drug information on best prescribing practices to address issues arising in each recipient’s own setting. Tools and supports to inter-professional teams in LTC homes and residents and their families. Academic Detailing and staff/resident supports were developed and delivered by the Centre for Effective Practice.
2. Personalized Practice Reports that provided providers with clinical quality indicators related to their prescribing practices. These reports were developed by Health Quality Ontario and are be confidential to providers.
As part of the Demonstration Project, 41 LTC homes were offered the combination of Personalized Practice Reports (offered by HQO) and Academic Detailing Service (offered by CEP). All interested providers (beyond the selected 41 sites) were also offered access to Personalized Practice Reports and all interested LTC homes had access to educational materials developed.
Participating sites began receiving the intervention in September of 2015, and sites were supported from 2015-2017.
For more information on the Appropriate Prescribing Demonstration Project, please contact [email protected]