Nielsen Matthew E, Birken Sarah A
Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC; Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC; Cancer Outcomes Research Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC; Cancer Outcomes Research Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
Urol Oncol. 2018 May;36(5):252-256. doi: 10.1016/j.urolonc.2018.02.010. Epub 2018 Mar 19.
The field of implementation science has been conventionally applied in the context of increasing the application of evidence-based practices into clinical care, given evidence of underusage of appropriate interventions in many settings. Increasingly, however, there is recognition of the potential for similar frameworks to inform efforts to reduce the application of ineffective or potentially harmful practices. In this article, we provide some examples of clinical scenarios in which the quality problem may be overuse and misuse, and review relevant theories and frameworks that may inform improvement activities.
鉴于在许多情况下适当干预措施未得到充分应用的证据,实施科学领域传统上一直应用于促进将循证实践应用于临床护理的背景中。然而,越来越多的人认识到,类似的框架有可能为减少无效或潜在有害实践的应用提供指导。在本文中,我们提供了一些临床场景的例子,其中质量问题可能是过度使用和误用,并回顾了可能为改进活动提供指导的相关理论和框架。