Research Fellow Senior Research Fellow Professor of Surgery & Public Health, Director, National Trauma Research Institute/Central Clinical School, Monash University, Melbourne, Australia Professorial fellow, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
J Eval Clin Pract. 2013 Oct;19(5):763-8. doi: 10.1111/j.1365-2753.2012.01835.x. Epub 2012 Apr 9.
Defining 'best practice' is one of the first and crucial steps in any Knowledge Translation (KT) research project. Without a sound understanding of what exactly should happen in practice, it is impossible to measure the extent of existing gaps between 'desired' and 'actual' care, set implementation goals, and monitor performance. The aim of this paper is to present a practical, stepped and interactive process to develop best practice recommendations that are actionable, locally applicable and in line with the best available research-based evidence, with a view to adapt these into process measures (quality indicators) for KT research purposes.
Our process encompasses the following steps: (1) identify current, high-quality clinical practice guidelines (CPGs) and extract recommendations; (2) select strong recommendations in key clinical management areas; (3) update evidence and create evidence overviews; (4) discuss evidence and produce agreed 'evidence statements'; (5) discuss the relevance of the evidence with local stakeholders; and (6) develop locally applicable actionable best practice recommendations, suitable for use as the basis of quality indicators.
Actionable definitions of local best practice are a prerequisite for doing KT research. As substantial resources go into rigorously synthesizing evidence and developing CPGs, it is important to make best use of such available resources. We developed a process for efficiently developing locally applicable actionable best practice recommendations from existing high-quality CPGs that are in line with current research evidence.
在任何知识转化（KT）研究项目中，定义“最佳实践”是首要且关键的步骤之一。如果对实践中应该具体发生什么没有一个清晰的理解，就不可能衡量“期望”和“实际”护理之间存在的差距程度，设定实施目标，并监测绩效。本文旨在提出一个实用、逐步和互动的流程，制定可操作、适用于本地情况且符合最佳现有基于研究证据的最佳实践建议，以便将这些建议转化为 KT 研究目的的流程措施（质量指标）。
我们的流程包括以下步骤：（1）确定当前高质量的临床实践指南（CPGs）并提取建议；（2）选择关键临床管理领域的强推荐；（3）更新证据并创建证据概述；（4）讨论证据并生成商定的“证据陈述”；（5）与当地利益相关者讨论证据的相关性；（6）制定适用于本地情况且可操作的最佳实践建议，适合用作质量指标的基础。
可操作的本地最佳实践定义是进行 KT 研究的前提。由于大量资源用于严格综合证据和制定 CPG，因此充分利用这些现有资源非常重要。我们开发了一种从现有高质量 CPG 中高效制定符合当前研究证据的适用于本地情况且可操作的最佳实践建议的流程。
