Hammerly Milt
Catholic Health Initiatives, Denver, Colo 80202, USA.
Am J Med Qual. 2002 Sep-Oct;17(5):189-94. doi: 10.1177/106286060201700506.
Individual practitioners and health care systems/organizations increasingly understand the rationale for collaborative medicine. An absence of collaboration can compromise the quality and safety of patient care. But having a rationale to provide collaborative medicine without also having a rational clinical strategy can be equally compromising to the quality and safety of patient care. Reasonable evidentiary criteria must be used to determine whether specific therapies merit inclusion or exclusion in a collaborative medicine model. Ranking therapies hierarchically on the basis of their risk-benefit ratio simplifies matching of therapies with the needs of the patient. A unifying taxonomy that categorizes all therapies (complementary/alternative and conventional) on the basis of how we think they work (presumed mechanisms of action) facilitates development of a clinical strategy for collaborative medicine. On the basis of these principles, a rational clinical strategy for collaborative medicine is described to help optimize the quality and safety of patient care.
个体从业者以及医疗保健系统/组织越来越理解协作医疗的基本原理。缺乏协作会损害患者护理的质量和安全性。但是,有提供协作医疗的基本原理却没有合理的临床策略,同样可能损害患者护理的质量和安全性。必须使用合理的证据标准来确定特定疗法是否值得纳入协作医疗模式或被排除在外。根据风险效益比将疗法进行分层排序,可简化疗法与患者需求的匹配。一个统一的分类法,根据我们对所有疗法(补充/替代疗法和传统疗法)作用方式的理解(假定的作用机制)对其进行分类,有助于制定协作医疗的临床策略。基于这些原则,描述了一种协作医疗的合理临床策略,以帮助优化患者护理的质量和安全性。