Manavi Saeed, Olyaee Manesh Alireza, Yazdani Shahram, Shams Lida, Nasiri Taha, Shirvani Armin, Emami Razavi Hasan
Dept. of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran.
Dept. of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran ; Dept. of Payment and Financing of Health System, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2013 Jul 1;42(7):758-66. eCollection 2013.
Regarding the role and importance of paradigm of evidence based practice and its remarkable impact on the effectiveness and efficiency of clinical services and healthcare, development of an integrated system seems necessary in order to manage dispersed data and ensure using evidence in clinical decision making, thus the aim of this study was designing a model for implementing national system of evidence based health care in Iran.
THIS PAPER IS A STUDY OF COMPARATIVE TYPE WHICH HAS BEEN WRITTEN IN THREE STAGES: investigation of structure and process of evidence based practice in selected countries, investigation and analysis of current status in Iran in this regard and recommendation of strategies which make model implementation feasible in the country. Such methods as review of literature, focus group discussion and Delphi technique were used for investigation.
According to studies, insuring an evidence based practice culture in the country requires a system called National Evidence Based Health Care System which consists of three subsystems including national system of clinical knowledge management, national evidence-based practice system and integrated national network of clinical effectiveness.
The ultimate goal of health care system in every country is maintaining and improving community health. Achievement of this goal depends on effectiveness of delivered services and consistency of the services with national and local priorities. In order to achieve clinical effectiveness, the best practice should be realized in the country, implementation of which requires a set of macro and micro strategies enabling facilitation, promotion or guaranteeing clinical knowledge application in the country.
鉴于循证实践范式的作用和重要性及其对临床服务和医疗保健的有效性和效率的显著影响，开发一个综合系统以管理分散的数据并确保在临床决策中使用证据似乎很有必要，因此本研究的目的是设计一个在伊朗实施国家循证医疗保健系统的模型。
本文是一项比较型研究，分三个阶段撰写：对选定国家循证实践的结构和过程进行调查，对伊朗在这方面的现状进行调查和分析，以及提出使该模型在该国可行的实施策略。采用文献综述、焦点小组讨论和德尔菲技术等方法进行调查。
根据研究，在该国确保循证实践文化需要一个称为国家循证医疗保健系统的系统，该系统由三个子系统组成，包括国家临床知识管理系统、国家循证实践系统和国家临床有效性综合网络。
每个国家医疗保健系统的最终目标是维护和改善社区健康。实现这一目标取决于所提供服务的有效性以及服务与国家和地方优先事项的一致性。为了实现临床有效性，应在该国实现最佳实践，而这需要一套宏观和微观策略，以促进、推广或保证该国临床知识的应用。
