Department of Physical Medicine and Rehabilitation, National Rehabilitation Hospital, Washington, DC 20010, USA.
PM R. 2009 Oct;1(10):941-50. doi: 10.1016/j.pmrj.2009.06.001. Epub 2009 Oct 1.
Best practice is a practice that, on rigorous evaluation, demonstrates success, has had an impact, and can be replicated. It is differentiated from its constituent parts, evidence-based practice and knowledge translation, by its general meaning and global purview. The purpose of this clinical review is to provide transparency to the concept and achievement of best practice in the context of rehabilitation medicine. The authors will review and analyze the roles of evidence-based practice and knowledge translation in rehabilitation medicine as they work to support best practice. Challenge areas will be discussed, including an evidential hierarchy in need of update, a lack of "high-level" research evidence, and delays in translating evidence to practice. Last, the authors will argue that rehabilitation medicine is well-positioned to effect change by promoting inclusion of emerging research methodologies and analytic techniques that better capture context-specific rehabilitation evidence, into the evidential hierarchy. Achieving best practice is dependent on this, as well as alignment of all key stakeholders, ranging from the patient, researchers and clinicians, to policymakers, payers, and others.
最佳实践是一种经过严格评估证明成功、具有影响力且可复制的实践。它与循证实践和知识转化不同，具有更广泛的含义和全球视野。本临床综述旨在提供康复医学背景下最佳实践概念和实现的透明度。作者将回顾和分析康复医学中循证实践和知识转化的作用，以支持最佳实践。讨论的挑战领域包括需要更新的证据层次结构、缺乏“高级”研究证据以及将证据转化为实践的延迟。最后，作者将认为，康复医学通过促进将更好地捕捉特定于康复的证据的新兴研究方法和分析技术纳入证据层次结构，从而能够更好地发挥作用。实现最佳实践取决于这一点，以及从患者、研究人员和临床医生到政策制定者、支付者和其他各方的所有主要利益相关者的一致性。
