Gross P A, Greenfield S, Cretin S, Ferguson J, Grimshaw J, Grol R, Klazinga N, Lorenz W, Meyer G S, Riccobono C, Schoenbaum S C, Schyve P, Shaw C
Hackensack University Medical Center, New Jersey 07601, USA.
Med Care. 2001 Aug;39(8 Suppl 2):II85-92.
Quality problems in medical care are not a new finding. Variations in medical practice as well as actual medical errors have been pointed out for many decades. The current movement to write practice guidelines to attempt to correct these deviations from recommended medical practice has not solved the problem.
In order to gain greater acceptance of these guidelines and to change the behavior of health care providers, the science of guideline implementation must be understood better.
A group of experts who have studied the problem of implementation in Europe and the United States was convened. This meeting summary enumerates the implementation methods studied to date, reviews the theories of behavioral change, and makes recommendation for effecting better implementation guidelines.
A research agenda was proposed to further our knowledge of effective evidence-based implementation.
医疗保健中的质量问题并非新发现。几十年来，医疗实践中的差异以及实际医疗差错一直被指出。当前编写实践指南以试图纠正这些与推荐医疗实践的偏差的行动并未解决问题。
为了使这些指南得到更广泛的接受并改变医疗服务提供者的行为，必须更好地理解指南实施科学。
召集了一组研究欧美实施问题的专家。本次会议纪要列举了迄今为止研究的实施方法，回顾了行为改变理论，并就制定更好的实施指南提出建议。
提出了一项研究议程，以增进我们对基于证据的有效实施的认识。
