Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury CT1 3NG, UK.
Clin J Am Soc Nephrol. 2009 Dec;4 Suppl 1:S23-9. doi: 10.2215/CJN.04270609.
The main sources of guidelines in kidney disease in the United Kingdom are the National Institute of Health and Clinical Excellence (NICE), the UK Renal Association, and the Scottish Intercollegiate Guideline Network (SIGN). These groups now all adopt similar methods of guideline development, but implementation methods differ and also vary in their effectiveness. The structure of UK health care lends itself to an integrated implementation strategy, and the United Kingdom is almost unique in being able to introduce simultaneously related changes that aid implementation nationally, thereby enabling implementation locally. Use of these strategies is variable with possibly too much reliance on existing systems that deliver predictable suboptimal results and a failure to embed implementation strategies into routine organizational structure. The next steps for us in the United Kingdom are to use service improvement methods to improve and sustain consistently implementation of evidence-based practice.
英国肾脏病指南的主要来源是国家卫生与临床优化研究所（NICE）、英国肾脏协会和苏格兰校际指南网（SIGN）。这些组织现在都采用类似的指南制定方法，但实施方法不同，效果也不同。英国医疗保健的结构适合采用综合实施策略，英国几乎是独一无二的，能够同时引入有助于全国实施的相关变革，从而实现本地实施。这些策略的使用情况各不相同，可能过于依赖现有的系统，这些系统只能带来可预测的次优结果，而且未能将实施策略嵌入常规组织结构中。我们在英国的下一步是使用服务改进方法来持续改进和维持基于证据的实践的实施。
