In the average family practice, 5-6% of the caseload is made up of complex patients with multiple co-morbidities and high health care needs.
Often these patients are part of a ‘special population’ – a diagnostic group that is seen relatively infrequently, but that places extraordinary demands on primary care practitioners in terms of specialized knowledge, practices and facilities.
Some examples of these types of patients include people with:
- spinal cord injuries
- acquired brain injuries
- multiple sclerosis
- Parkinson’s disease
- cerebral palsy
- developmental and intellectual disabilities
Actionable Nuggets are a tool to assist family practitioners to provide high quality, evidence -based care to patients with conditions that are low prevalence, but high urgency and complexity.
Actionable Nuggets are brief, focused ‘electronic postcards’ that deal with the most common and pressing health problems that these patients present with in primary care. They are typically 300-350 words, and can be read in under a minute, BUT they represent the synthesis of the best evidence since 2000 on the topic – usually 40-100 peer-reviewed citations.
They are assembled by:
- multiple problem-specific scoping reviews of the peer-reviewed literature
- consensus-based review by an Expert Panel
- synthesis by knowledge translation experts
- re-review at approximately 3-year intervals to ensure they represent the latest evidence
For more on methodology, click here.
Actionable Nuggets consist of:
- A statement of a problem typically seen in primary care;
- A recommendation for action by the family physician – ie., the Actionable Nugget itself;
- A description of evidence-based best practice in primary care;
- Specific practice tool reproduced with permission of the original authors;
- The key reference, which forms the basis for the Actionable recommendation;
- A full reference list for each Nugget;
- The copyright date of each Nugget, so readers can judge the currency of the information.
Actionable Nuggets for Spinal Cord Injury 