Cook Chad E, Beneciuk Jason M, George Steven Z
J Orthop Sports Phys Ther. 2022 Feb;52(2):63-66. doi: 10.2519/jospt.2022.10961.
Procedural fidelity involves delivering the correct guideline-supported treatment choice, in its designed manner, over the full care episode of the patient. Procedural drift is a subcomponent of procedural fidelity that involves performing the right treatment the right way initially, then drifting toward suboptimal treatment over time. Procedural drift occurs most often when providing intricate, patient-centered interventions that require attention to subtle nuances that potentially maximize their effectiveness. Drift comes from the belief that subtle nuances do not matter, or from a lack of motivation or incentive to maintain high fidelity. Strategies to reduce drift in practice include investment in early, high-quality training; using checklists and manuals when providing an intervention; using risk-adjusted patient data as a checks-and-balances system; and incorporating measures of drift in the practitioner's annual review. .
程序保真度包括在患者的整个护理过程中，以设计好的方式提供正确的、有指南支持的治疗选择。程序偏差是程序保真度的一个子成分，它涉及最初以正确的方式进行正确的治疗，但随着时间的推移逐渐转向次优治疗。程序偏差最常发生在提供复杂的、以患者为中心的干预措施时，这些干预措施需要关注可能使其效果最大化的细微差别。偏差源于认为细微差别无关紧要的信念，或者源于缺乏保持高保真度的动力或激励。在实践中减少偏差的策略包括投资早期的高质量培训；在提供干预措施时使用检查表和手册；使用经过风险调整的患者数据作为制衡系统；以及在从业者的年度评估中纳入偏差衡量指标。
