Klinik Kalite Değerlendirmesinde Klinik Protokollerin Kullanımı

Yıl 2023, , 33 - 47, 30.06.2023

Mustafa Said Yıldız

https://doi.org/10.52148/ehta.1241750

Öz

Klinik protokollerin en önemli kullanım amaçlarından biri sağlıkta kaliteyi iyileştirmektir. Klinik protokolleri klinik kalite göstergeleri ile ilişkilendirmek için prosedürlerin belirlenmesi, klinik kalite iyileştirme süreçlerinin geliştirilmesi ve uygulanması sağlık sistemine hayati katkılar sağlayacaktır. Bu çalışmada; klinik kılavuzların medikal değerlendirme kriteri, performans ölçeği ve kalite standardına dönüşümü için izlenecek yol; klinik göstergelerin uygulayıcılarca benimsenmesi için gereklilikler ve klinik kılavuzlardan performans göstergeleri oluşturmak için bir yol haritası paylaşılmıştır. Ayrıca Sağlık Bakanlığı bünyesinde klinik kalite çalışmalarında klinik protokollerin kullanımı konusunda gelişmelere de yer verilmiştir.

Anahtar Kelimeler

klinik uygulama kılavuzu, klinik protokol, sağlık hizmetlerinin kalitesi

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Using Clinical Practice Protocols To Evaluate Clinical Quality Of Care

Öz

Improving quality in healthcare is one of the most important aims of clinical protocols. Determination of procedures in order to establish relationship between clinical protocols and clinical quality indicators, development of clinical quality improvement processes and implementing quality improvement projects would provide vital contributions to the health system. In this study; the procedure to be followed for the adaptation of clinical guidelines into medical evaluation criterias, performance indicators and quality standards; requirements for practitioner adoption of clinical indicators and a roadmap for generating performance indicators from clinical guidelines were also shared. In addition, recent advances in the use of clinical protocols in clinical quality efforts within the Ministry of Health were also included.

Anahtar Kelimeler

clinical guidelines, clinical protocol, quality of healthcare

Proje Numarası

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Kaynakça

• Agency for Health Care Policy and Research (1995) Entwistle. Using clinical practice guidelines to evaluate quality of care. 1. Issues. Rockville, MD: US Department of Health and Human Services, Public Health Services (AHCPR publication No 95-0045.)
• Blozik, E., Nothacker, M., Bunk, T., Szecsenyi, J., Ollenschläger, G., & Scherer, M. (2012). Simultaneous development of guidelines and quality indicators -- how do guideline groups act? A worldwide survey. International journal of health care quality assurance, 25(8), 712–729. https://doi.org/10.1108/09526861211270659
• Bouchard, C., & Jean, O. (2017). Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?. The International journal of health planning and management, 32(4), e299–e315. https://doi.org/10.1002/hpm.2376
• Entwistle, V. A., Watt, I. S., Davis, H., Dickson, R., Pickard, D., & Rosser, J. (1998). Developing information materials to present the findings of technology assessments to consumers. The experience of the NHS Centre for Reviews and Dissemination. International journal of technology assessment in health care, 14(1), 47–70. https://doi.org/10.1017/s0266462300010527
• Feder G., Eccles M., Grol R., Griffiths C., Grimshaw J. (1999). Using clinical guidelines, Education and debate, BMJ, 318: 728-30
• Gude, W. T., Brown, B., van der Veer, S. N., Colquhoun, H. L., Ivers, N. M., Brehaut, J. C., Landis-Lewis, Z., Armitage, C. J., de Keizer, N. F., & Peek, N. (2019). Clinical performance comparators in audit and feedback: a review of theory and evidence. Implementation science : IS, 14(1), 39. https://doi.org/10.1186/s13012-019-0887-1
• Huttin, C. (1997). The Use of Clinical Guidelines to Improve Medical Practice: Main Issues in the United States International Journal for Quality in Health Can, 9(3):207-214
• Institute of Medicine – IOM (1990). Committee on Clinical Practice Guidelines. Clinical practice guidelines: directions for a new program. Field MJ, Lohr KN, editors. Washington, DC: National Academy Press.
• Institute of Medicine - IOM (2011). Committee on Standards for Developing Trustworthy Clinical Practice Guidelines; Graham R, Mancher M, Miller Wolman D, et al., editors. Clinical Practice Guidelines We Can Trust. Washington (DC): National Academies Press (US);. 6, Promoting Adoption of Clinical Practice Guidelines. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209543/
• Klinik Kalite Programı (2023). Kolorektal Kanser Gösterge Kartları, https://shgmklinikkalite.saglik.gov.tr/TR-93561/kolorektal-kanser-gosterge-kartlari.html Erişim tarihi: 24.01.2023.
• Kolorektal Kanser Klinik Protokolü (2019). T.C. Sağlık Bakanlığı, Sağlık Hizmetleri Genel Müdürlüğü, Sağlık Teknolojisi Daire Başkanlığı, Ankara, 2019 https://shgmargestddb.saglik.gov.tr/Eklenti/36748/0/kolorektalkanserklinikprotokolu20200227pdf.pdf Erişim tarihi: 24.01.2023.
• Mickan S, Burls A, Glasziou P (2011). Patterns of ‘leakage’ in the utilisation of clinical guidelines: a systematic review, Postgrad Med J, 87:670e679. doi:10.1136/pgmj.2010.116012
• Nothacker M et al. (2016). Reporting standards for guideline-based performance measures. Implementation Science, 11:6. doi: 10.1186/s13012-015-0369-z.
• Panteli D, Legido-Quigley H, Reichebner C, et al. Clinical Practice Guidelines as a quality strategy. In: Busse R, Klazinga N, Panteli D, et al., editors. Improving healthcare quality in Europe: Characteristics, effectiveness and implementation of different strategies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2019. (Health Policy Series, No. 53.) 9. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549283/
• Rotter T, de Jong RB, Lacko SE, et al. Clinical pathways as a quality strategy. In: Busse R, Klazinga N, Panteli D, et al., editors. Improving healthcare quality in Europe: Characteristics, effectiveness and implementation of different strategies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2019. (Health Policy Series, No. 53.) 12. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549262/
• Shapiro, D. W., Lasker, R. D., Bindman, A. B., & Lee, P. R. (1993). Containing costs while improving quality of care: the role of profiling and practice guidelines. Annual review of public health, 14, 219–241. https://doi.org/10.1146/annurev.pu.14.050193.001251
• Szecsenyi, J., Broge, B., Eckhardt, J., Heller, G., Kaufmann-Kolle, P., & Wensing, M. (2012). Tearing down walls: opening the border between hospital and ambulatory care for quality improvement in Germany. International journal for quality in health care : journal of the International Society for Quality in Health Care, 24(2), 101–104. https://doi.org/10.1093/intqhc/mzr086
• Willis, T. A., West, R., Rushforth, B., Stokes, T., Glidewell, L., Carder, P., Faulkner, S., Foy, R., & ASPIRE programme team (2017). Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study. PloS one, 12(7), e0177949. https://doi.org/10.1371/journal.pone.0177949
• Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ (Clinical research ed.), 318(7182), 527–530. https://doi.org/10.1136/bmj.318.7182.527
• Yan AF, Chen Z, Wang Y, Campbell JA, Xue Q-L, Williams MY, Weinhardt LS, Egede LE (2022) Effectiveness of social needs screening and interventions in clinical settings on utilization, cost, and clinical outcomes: a systematic review, Health Equity 6:1, 454–475, DOI: 10.1089/heq.2022.0010
• Yıldız MS (2018). Initiating A Clinical Quality Measurement and Evaluation System: A Case Study From Turkey, Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 9(4):465-468, https://doi.org/10.31067/0.2018.68 A