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De la mejor evidencia a la mejor práctica: implementación efectiva del cambio en el cuidado de los pacientes
Richard Grol1, Jeremy Grimshaw
1Centre for Quality of Care Research (WOK), Universities of Nijmegen and Maastricht, PO Box 9101, WOK 229 6500 HB, Nijmegen, Netherlands. r.grol@wok.umcn.nl
Lancet (London, England)
|October 22, 2003
Resumen
La implementación de la práctica basada en la evidencia se enfrenta a desafíos, ya que los pacientes a menudo reciben una atención subóptima. Las estrategias integrales y de varios niveles adaptadas a contextos específicos son las más efectivas para cambiar la práctica médica y mejorar los resultados de los pacientes.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Mejora de la Práctica Médica Mejora de la Práctica Médica
- Implementación de la medicina basada en la evidencia.
Sus antecedentes:
- Existen brechas significativas entre la evidencia clínica / directrices y la práctica médica de rutina.
- La atención subóptima del paciente, incluido el uso inadecuado o excesivo de tratamientos, es común.
- Las estrategias efectivas para traducir la evidencia en la práctica siguen sin estar claras.
Objetivo del estudio:
- Proporcionar una visión general de los conocimientos actuales sobre las iniciativas para cambiar la práctica médica.
- Identificar enfoques efectivos y eficientes para la implementación de la evidencia.
- Comprender los factores que influyen en la adopción de las directrices clínicas.
Principales métodos:
- Revisión sistemática de las iniciativas destinadas a cambiar la práctica médica.
- Análisis de la evidencia con respecto a la efectividad de las diferentes estrategias de implementación.
- Evaluación de los factores que influyen en el cambio de comportamiento en los entornos de atención médica.
Principales resultados:
- El cambio de comportamiento en la práctica médica es alcanzable, pero requiere intervenciones integrales y de varios niveles.
- Las estrategias deben adaptarse a entornos específicos, grupos objetivo y la naturaleza de la evidencia.
- Ningún enfoque único supera universalmente a otros en todas las situaciones.
Conclusiones:
- La implementación efectiva de la evidencia y las directrices requiere estrategias personalizadas y multifacéticas.
- Comprender las barreras y los facilitadores es crucial para un cambio de práctica exitoso.
- Un enfoque específico del contexto es esencial para optimizar la atención al paciente a través de la traducción de la evidencia.
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