Using Clinical Practice Guidelines: Building and Applying a Guideline-Based Performance Measurement System. Volume 1. Acute Postoperative Pain and Urinary Incontinence

摘要

The American Medical Review Research Center (AMRRC) evaluated the Agency for Health Care Policy and Research (AHCPR)-supported practice guidelines for postoperative pain management and urinary incontinence through the development of performance measurement systems for these guidelines. The objectives of the project were to (1) determine whether the guidelines for acute postoperative pain, urinary incontinence could be translated into quality and utilization review criteria and performance measures; (2) to test the guideline-based measurement systems for use by Medicare peer review organizations in the review of care provided to Medicare patients; (3) to identify ways in which the guidelines and guideline development process could be improved. To meet these objectives, AMRRC, with the assistance from five peer review organization (PROs), developed and tested prformance measurement systems for the practice guidelines. The goal was to create guideline performance measurement systems with a high degree of validity, clarity, clinical applicability, clinical flexibility, documentation, and computer compatibility. Each system was pilot tested after development. The draft architectural scheme is provided.