Health system processes shape and define health care and the medical experience of patients, health care practitioners, and society at large. These processes range from targeted mandates, such as gown and glove precautions for patient contact or automated computer alerts, to wider choices, such as deciding how to respond to medical emergencies, how to use (or not use) performance metrics or patient satisfaction surveys, what new health care facilities to build, or even how to finance health care costs and medical insurance. Given their unquestionable importance, we contend that health system processes should be routinely evaluated with randomized controlled trials (RCTs).
Ioannidis JPA, Prasad V. Evaluating Health System Processes With Randomized Controlled Trials. JAMA Intern Med. 2013;173(14):1279–1280. doi:10.1001/jamainternmed.2013.1044