Solberg L I, Kottke T E, Brekke M L, Conn S A, Magnan S, Amundson G
Group Health Foundation/Health Partners, Minneapolis, MN, USA.
Eff Clin Pract. 1998 Aug-Sep;1(1):33-8.
To examine the presence and comprehensiveness of organized processes and systems in a sample of primary care clinics shown to have high variation in rates of providing preventive services.
Survey study.
44 primary care clinics recruited for a scientific trial of a quality improvement intervention to improve preventive services.
647 clinicians and nurses.
The presence of 10 organized prevention processes for eight adult preventive services as reported by those clinicians and nurses on a detailed written survey.
In more than 50% of clinics, 7 of the 10 prevention processes were reported to be absent for all eight services. Only the follow-up process was commonly present; this was also the only process that was usually present for most applicable services.
The paucity of recognizable organized processes to support the systematic delivery of adult preventive services in clinics with highly varying rates of providing these services supports the idea that lack of systems may be an important source of the variability and low rates. Most of the existing processes are fragmented and do not function across multiple preventive services.
在一组预防服务提供率差异较大的基层医疗诊所样本中，检查有组织的流程和系统的存在情况及全面性。
调查研究。
为一项改善预防服务的质量改进干预科学试验招募的44家基层医疗诊所。
647名临床医生和护士。
这些临床医生和护士在一份详细的书面调查问卷中报告的针对八项成人预防服务的10个有组织的预防流程的存在情况。
在超过50%的诊所中，八项服务的10个预防流程中有7个被报告不存在。只有随访流程普遍存在；这也是大多数适用服务通常唯一存在的流程。
在提供这些服务的比率差异很大的诊所中，缺乏可识别的有组织的流程来支持成人预防服务的系统提供，这支持了以下观点，即系统的缺乏可能是差异和低比率的一个重要来源。现有的大多数流程都是零散的，不能跨多种预防服务发挥作用。
