Designing standardized clinical protocols: some organizational and behavioral issues.
In the present environment, the clinical ordering patterns of hospital-based physicians can be expected to come under increasing scrutiny. This paper considers three major aspects of the case for inpatient clinical ordering protocols. First, it reviews the argument that hospitals do not, at present, exercise adequate management over physician-triggered resource consumption. Subsequently, the paper examines existing but partial protocol models in the United States and Scandinavia that could provide a basis for an adequate physician management system. In its third section, the paper explores the fundamental characteristics of a full-fledged Standardized Clinical Protocol (SCP) system, developing two alternative 'ideal-type' models for further discussion. The paper concludes with the argument that physicians, rather than economists or politicians, should control the design of future protocol systems.
D001519:Behavior; D005060:Europe; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards*; D008962:Models, Theoretical; D011364:Professional Practice / Q000592:standards*; D012052:Reimbursement, Incentive; D014481:United States