Diamond L H, Daly D C
The MEDSTAT Group, a Thomson health care information company, Washington, DC 20008, USA.
Adv Ren Replace Ther. 1999 Jan;6(1):28-35. doi: 10.1016/s1073-4449(99)70005-1.
The development and release of the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Clinical Practice Guidelines marks an important step in the on-going process of improving the renal dialysis patient's outcomes. The Forum of End-Stage Renal Disease (ESRD) Networks' role in this process should be considered within the context of its mission and the ESRD Networks' Congressional mandate. In addition, facilitating the implementation of the NKF-DOQI Guidelines is one component of the Forum's current quality-related agenda. Environmental trends and current research indicate a variety of factors critical to the successful implementation of the NKF-DOQI Guidelines. The Forum's plan encompasses each of the following key elements: defining and evaluating the Guidelines and clinical performance measures (CPMs); prioritizing and locally disseminating NKF-DOQI Guidelines; converting NKF-DOQI Guidelines into CPMs; expanding the information infrastructure; and conducting quality activities and engaging local physicians. Keeping in mind the broader national agenda for quality improvement in the renal community, including continuing medical education programs focused on quality measurement and improvement tools and techniques, developing decision support tools and increasing on-line access to evidence-based reports and literature is important as well. Carrying out the Forum's plan for implementing the NKF-DOQI Guidelines, in collaboration with national nephrology professional and patient organizations, will facilitate Guideline adoption and use across the renal community.
美国国家肾脏基金会透析预后质量倡议(NKF-DOQI)临床实践指南的制定与发布,标志着在持续改善肾透析患者预后的进程中迈出了重要一步。终末期肾病(ESRD)网络在这一进程中的作用,应结合其使命以及ESRD网络的国会授权来考量。此外,推动NKF-DOQI指南的实施是该论坛当前质量相关议程的一个组成部分。环境趋势和当前研究表明,多种因素对NKF-DOQI指南的成功实施至关重要。该论坛的计划涵盖以下关键要素:界定和评估指南及临床绩效指标(CPM);对NKF-DOQI指南进行优先排序并在当地传播;将NKF-DOQI指南转化为CPM;扩展信息基础设施;开展质量活动并吸引当地医生参与。牢记肾脏领域更广泛的全国质量改进议程,包括专注于质量测量以及改进工具和技术的继续医学教育项目,开发决策支持工具并增加在线获取循证报告和文献的机会也很重要。与全国肾脏病专业和患者组织合作,实施该论坛关于实施NKF-DOQI指南的计划,将促进整个肾脏领域对指南的采用和使用。