Kibbe D C, Kaluzny A D, McLaughlin C P
Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill.
Jt Comm J Qual Improv. 1994 Apr;20(4):181-91. doi: 10.1016/s1070-3241(16)30060-8.
Will guidelines reduce inappropriate care in clinical practice? Although expectations are high, it is likely that guidelines are insufficient. Clinical guidelines help physicians to "do the right thing," but fail to address the corresponding issue of how to help organizations, departments, and health care workers do the right thing "in the right way." Attention needs to be given to the context in which guidelines function and the process by which guidelines are adopted in health care organizations. Linking guidelines with the improvement of ongoing clinical and organizational processes is critical to ensure their intended effect.
临床实践指南能否减少不适当的医疗行为？尽管人们寄予厚望，但指南可能并不完善。临床指南有助于医生“做正确的事”，却未能解决如何帮助机构、科室及医护人员“以正确的方式做正确的事”这一相应问题。需要关注指南发挥作用的背景以及医疗保健机构采用指南的过程。将指南与持续的临床和组织流程改进相联系，对于确保其预期效果至关重要。
