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Implementation of clinical practice guidelines in patient care has been modest, states the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, even though numerous guidelines applicable to a wide range of clinical services exist. Current standards neither require nor pose a barrier to their use.
The Joint Commission has proposed new standards for inclusion in the leadership chapter of the Comprehensive Accreditation Manual for Hospitals that would facilitate use of guidelines, while recognizing they must be reviewed carefully and often modified locally to make them suitable for use. The use of clinical guidelines promulgated by peer-reviewed organizations has been shown invariably to improve care and cut costs, either by decreasing lengths of stay or utilization. Nonethe less, physicians have been slow to adopt guidelines, complaining that they take away their prerogatives in patient care.
(Editor's note: The new standards can be seen and responded to on the Internet at www.jcaho.org/pubedmul/publicat/std_rel.htm.) n