Translating practice guidelines into patient care - Guidelines at the bedside

Practice guidelines have been developed by a myriad of government, subspeci alty, and local organizations in an attempt to reduce undesirable variation s in care and to improve the quality of care. Despite the current enthusias m driving the creation of thousands and thousands of guidelines, their long evity will depend on the ability to demonstrate measurable improvements in patient care caused by the dissemination and implementation of guidelines, in order for guidelines to improve care, they must influence the decisions that physicians and other health-care providers make as they care for patie nts on a day-to-day basis. Studies on this topic show that some guideline i mplementation strategies are consistently effective, meaning that they lead to changes in care that benefit patients. Other strategies have been shown to be consistently ineffective. Using an evidence-based approach to select ing guideline dissemination and implementation strategies may facilitate th e greatest chance of success, and enhance the probability that patient care will be meaningfully improved as a result of these efforts.