Baker R, Fraser R C
Eli Lilly National Clinical Audit Centre, Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, UK.
Fam Pract. 1997 Apr;14(2):107-11. doi: 10.1093/fampra/14.2.107.
It is commonly accepted that ownership is an important factor in determining the acceptability and use of protocols or guidelines.
We aimed to determine whether Medical Audit Advisory Groups (MAAGs) are prepared to accept and use audit protocols developed systematically by an external agency.
A postal questionnaire was sent to all 105 MAAG chairmen in England and Wales to seek their views on the external development of protocols, the inclusion of evidence-based prioritized criteria, the general design of the protocols issued by the Lilly Audit Centre and the numbers of practices reported by MAAGs as making use of at least one of the first four protocols issued.
Ninety-five MAAGs (90%) responded. Of these, 86% were in favour of the external development of protocols, and 98% and 94%, respectively, found evidence-based and prioritized criteria valuable; 98% felt the overall design and content of the Audit Centre protocols were excellent or good. A total of 1018 practices was known to have made use of one of these protocols, 261 taking part in multi-practice audits organized by their MAAGs.
Ownership is not necessarily more important than scientific credibility and/or perceived utility. Externally developed audit protocols containing evidence-based, prioritized review criteria are acceptable to MAAGs, which are prepared to recommend their use in practice. Accordingly, such systematically developed protocols offer a promising and practical method for improving clinical effectiveness. Further research is needed, however, to determine the comparative impact on standards of care of protocols and other methods such as clinical guidelines.
人们普遍认为，所有权是决定方案或指南的可接受性及使用情况的一个重要因素。
我们旨在确定医疗审计咨询小组（MAAGs）是否准备好接受并使用由外部机构系统制定的审计方案。
向英格兰和威尔士所有105位MAAG主席发送了一份邮政调查问卷，以征求他们对方案的外部制定、基于证据的优先标准的纳入、礼来审计中心发布的方案的总体设计，以及MAAGs报告的使用了至少前四个发布方案中的一个的医疗机构数量的看法。
95个MAAGs（90%）做出了回应。其中，86%赞成方案的外部制定，98%和94%分别认为基于证据的标准和优先标准很有价值；98%觉得审计中心方案的总体设计和内容优秀或良好。已知共有1018家医疗机构使用了其中一个方案，261家参与了由其MAAG组织的多机构审计。
所有权不一定比科学可信度和/或感知效用更重要。包含基于证据的、优先审查标准的外部制定的审计方案为MAAGs所接受，MAAGs准备在实践中推荐使用这些方案。因此，这种系统制定的方案为提高临床疗效提供了一种有前景且实用的方法。然而，需要进一步研究来确定方案以及其他方法（如临床指南）对护理标准的相对影响。
