[Variability in neurology care. Tools for quality improvement].
Medical practice variability is a common problem that can reduce the quality of health assistance. We can introduce several tools, like protocols (P), clinical practice guidelines (CPG) and clinical pathways (CP) that allow us to reduce it. CPG must be based in a review of medical evidence and it is the main difference with P. Also it will be more expensive to develop, and its final implementation is more difficult. On the other hand, P are born from simple consensus and its application are easier and widely in medicine. CP have recently appeared in the medical world to try to resolve the problems of the applications of P and CPG in clinical daily practice. They describe in detail medical attention in a systematic, temporal way. They are very similar to a process management and facilitate the interaction of all medical picture actors (manager, health personal and patients). One of the limitations of this tool is that it has not widely application. It is more useful in complex, frequent, very expensive medical process, with known predictable clinical evolution. Once developed, the control and the temporal improvement of these processes. It is very probable that the development of these tools can increase the quality of neurological assistance in Spain in the next future.
Escudero Torrella
J
J
Sección de Neurología, Hospital General de Castellón, Ctra. de Benicassim, s/n, 12004 Castellón. jescudero@meditex.es
D019091:Critical Pathways; D006801:Humans; D009462:Neurology / Q000592:standards*; D010346:Patient Care Management / Q000592:standards*; D017410:Practice Guidelines as Topic; D013030:Spain; D017749:Total Quality Management / Q000379:methods*