Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care
Evaluation of general practice computer templates. Lessons from a pilot randomised controlled trial.
We conducted a pilot r and omised trial of computerised templates for the management of asthma and diabetes in general practice in six general practice s in North London . Uptake of the guidelines by general practitioners and practice nurses was assessed using qualitative ( semi-structured interviews design ed to assess the users ' views ) and quantitative ( change in use of the template during the study period ) outcome measures . The practice nurses used the templates frequently but general practitioners rarely used them . Several reasons were offered for non-use of the templates , such as the length of the template and non-involvement in the care of asthma or diabetes . Despite this , however , health professionals were favourably disposed to the use of templates for general clinical care . Pilot investigations of computerised templates are best achieved by observational or quasi-experimental methods rather than a r and omised controlled trial . The use of both qualitative and quantitative methods in this study allowed exploration of the barriers to use of computers
Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care