Implementing Clinical Practice Guidelines
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Effect of Interventions for Implementing Clinical Practice Guidelines
The Norwegian Directorate of Health develops clinical practice guidelines, and requested the Norwegian Knowledge Centre for the Health Services to summarise research findings on the effectiveness of guideline implementation interventions. This report is an overview of existing systematic reviews. Key findings from the identified systematic reviews are that:1. Implementation interventions such as electronic decision-support, educational meetings, outreach visits, audit and feedback, and tailored interventions are probably effective, but: The size of the effect varies.The effect on clinical practice is most often moderate; The expected effect on health outcomes is modest. For other of the interventions, the size of the effect varied considerably across studies. It is difficult to explain this variation. Consequently, it is uncertain how much these interventions will improve adherence to clinical guidelines. For some measures, such as financial incentives and public release of performance data, evidence is lacking or scarce. We therefore cannot say how effective these types of interventions are.
Implementing Clinical Practice Guidelines
This book explains how to implement clinical practice guidelines effectively in order to help guideline users at any level get their job done. It offers a systematic approach to guideline implementation based on understanding what clinical guidelines are, how they work, and how implementation techniques that have proved effective in other areas can be used to help implement them. The book includes real case scenarios of guidelines implementation, and questions and answers throughout the text regarding: Solving clinical problems using clinical algorithms Developing and constructing practical guidelines Tailoring guidelines Implementing clinical practice guidelines Evaluating and monitoring clinical practice guidelines
Clinical Practice Guidelines We Can Trust
Author: Institute of Medicine
language: en
Publisher: National Academies Press
Release Date: 2011-07-16
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.