Empirical Grounding of Guideline Implementation in Cooperative Clinical Care Situations
Inger Dybdahl Sørby, Øystein Nytrø, Thomas Brox Røst · 2007
Abstract. Clinical practice guidelines and protocols are designed in order to fulfill the goals of EBM and to achieve best practice in care and treatment. These idealized decision process models present a highly abstract view of actual clinical practice. In this paper, we discuss how methodical observations of clinical care situations and trajectories of care activities can be used to study and improve guideline implementation, the process of transforming a guideline into a plan for clinical work. This is a step towards an ideal empirically grounded guideline lifecycle. We present a framework and concepts for representing observable attributes of situations, actors and action trajectories. The example data that are presented in the paper are taken from an observational study at a local hospital. 1