The use of continuous quality improvement methods in the development and dissemination of medical practice guidelines.
The federal government is currently supporting the development and dissemination of clinical practice guidelines. Physicians fear that payers who promote guidelines are more interested in reducing variation to control their behavior and contain health care spending than in improving quality of care. There is also apprehension that guidelines will shift the responsibility for quality to parties external to the physician-patient relationship and the local professional community. Continuous quality improvement (CQI) methods provide an avenue for physician responsibility and participation in guideline development which can alleviate these concerns. This article describes the efforts of one health maintenance organization (HMO) to use CQI techniques to mobilize plan physicians to develop, disseminate, and implement practice guidelines in a manner that satisfies the needs of physicians, patients, and the HMO.
Burns
L R
LR
Department of Management and Policy, University of Arizona, Tucson.
Denton
M
M
Goldfein
S
S
Warrick
L
L
Morenz
B
B
Sales
B
B
D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001130:Arizona; D011307:Drug Prescriptions / Q000592:standards; D006279:Health Maintenance Organizations / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007255:Information Services / Q000458:organization & administration*; D010437:Peptic Ulcer / Q000188:drug therapy; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D013997:Time Factors; D014481:United States
D000897:Anti-Ulcer Agents