Clinical practice guidelines and performance measures in ESRD.

Abstract

There is considerable variation in process or outcome measures in dialysis centers across the United States. Continuous quality improvement (CQI) techniques help multidisciplinary care teams assess current care and design strategies to improve outcomes. Evidence-based medicine facilitates the use of the current best evidence from clinical care research to improve patient care. Clinical practice guidelines, which are systematic statements that assist practitioner and patient decisions, are helpful in framing strategies to improve care. Clinical performance measures will provide measurement tools to CQI teams. Clinical decisions depend not only on research evidence in the literature, but also on clinical expertise, patient preferences, and constraints, such as policies, community standards, and budgetary limitations. As care teams use practice guidelines to improve outcomes, results of the CQI process may allow for the refinement of practice guidelines.