An evidence-based approach to evaluating and improving clinical practice: guideline development.

Group Health Cooperative of Puget Sound has developed a model for evaluating and improving clinical practice based on an explicit, evidence-based approach. It is designed to identify gaps between current and optimal practices, and to bring about changes in physician behavior so that health care outcomes (health status, patient satisfaction, provider satisfaction, cost/utilization) are maximized. This model stresses the importance of a rigorous process in looking objectively at evidence in working to improve outcomes. Discrete tools have been developed which help teams move successfully from problem identification to the ongoing evaluation and improvement of a new clinical practice.