Integrating guidelines with continuous quality improvement: doing the right thing the right way to achieve the right goals.

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.