scholarly journals Guidelines and Safety Practices for Improving Patient Safety

Author(s):  
Walter Ricciardi ◽  
Fidelia Cascini

AbstractThis chapter explains why clinical practice guidelines are needed to improve patient safety and how further research into safety practices can successfully influence the guideline development process. There is a description of the structured process by which guidelines that aim to increase the likelihood of a higher score are created. Proposals are made relating to (a) the live updating of individual guideline recommendations and (b) tackling challenges related to the improvement of guidelines.

2015 ◽  
Vol 29 (6) ◽  
pp. 294-296 ◽  
Author(s):  
A Hillary Steinhart ◽  
Aida Fernandes

A series of clinical practice guidelines were recently developed by the Canadian Association of Gastroenterology (CAG) to provide clinicians with recommendations for the medical management of nonhospitalized ulcerative colitis (UC) patients. These guidelines were developed, reviewed and agreed on by expert clinicians and methodologists. Following the finalization of the guidelines, a group of patients with UC as well as several inflammatory bowel disease clinicians, were brought together for a half-day workshop to provide feedback from the patient perspective. At the workshop, the guideline development process was described and the guidelines were reviewed to ensure comprehension. Patients then had the opportunity to provide their insight to the relevance of the guideline development process and the content of the guidelines as it related to their personal experiences with UC. The patient group believed that, although the new guidelines will be a tremendous resource for the health care provider community, a more ‘lay-friendly’ version would better facilitate dialogue between patients and their health care practitioners. The importance of the patient/physician relationship is paramount when making decisions regarding treatment plans, in which patient preferences play a key role in determining the most appropriate therapy and dosing regimen, which, in turn, impact the likelihood of adherence to the treatment plan. It was also believed that quality of life issues were not fully addressed in the guidelines. Much could be learned from shared experiences and coping strategies that would empower patients to take charge of their health and become equal partners with their care providers.


Author(s):  
Kristin M. Aakre ◽  
Michel R. Langlois ◽  
Joseph Watine ◽  
Julian H. Barth ◽  
Hannsjörg Baum ◽  
...  

AbstractCorrect information provided by guidelines may reduce laboratory test related errors during the pre-analytical, analytical and post-analytical phase and increase the quality of laboratory results.Twelve clinical practice guidelines were reviewed regarding inclusion of important laboratory investigations. Based on the results and the authors’ experience, two checklists were developed: one comprehensive list including topics that authors of guidelines may consider and one consisting of minimal standards that should be covered for all laboratory tests recommended in clinical practice guidelines. The number of topics addressed by the guidelines was related to involvement of laboratory medicine specialists in the guideline development process.The comprehensive list suggests 33 pre- analytical, 37 analytical and 10 post-analytical items. The mean percentage of topics dealt with by the guidelines was 33% (median 30%, range 17%–55%) and inclusion of a laboratory medicine specialist in the guideline committee significantly increased the number of topics addressed. Information about patient status, biological and analytical interferences and sample handling were scarce in most guidelines even if the inclusion of a laboratory medicine specialist in the development process seemingly led to increased focus on, e.g., sample type, sample handling and analytical variation. Examples underlining the importance of including laboratory items are given.Inclusion of laboratory medicine specialist in the guideline development process may increase the focus on important laboratory related items even if this information is usually limited. Two checklists are suggested to help guideline developers to cover all important topics related to laboratory testing.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melinda Boss ◽  
Jennifer Turner ◽  
Patrick Boss ◽  
Peter Hartmann ◽  
Douglas Pritchard ◽  
...  

Abstract Background Health professionals caring for women and infants experiencing difficulty with breastfeeding have reported deficiencies in evidence-based lactation knowledge. LactaMap is an online lactation care support system with more than 100 clinical practice guidelines to support breastfeeding care. Clinical practice guidelines support medical decision-making by summarising scientific evidence into systematically developed statements for specific clinical circumstances. Both common-sense and theory-based approaches have been used for guideline development and debate continues regarding which is superior. LactaMap clinical practice guidelines were created over the course of 5 years using a common-sense approach that was refined inductively. The aim of this study was to incorporate a theory-based framework approach into the methodology for ongoing update and review of LactaMap clinical practice guidelines. Methods The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was chosen as the framework-based approach to appraise LactaMap guideline quality. The study was conducted in two phases. The first phase appraised all 103 original LactaMap guidelines. The second phase appraised a subset of 15 updated LactaMap guidelines using improved methodology guided by phase 1, as well as 15 corresponding original (un-updated) guidelines. Results Mean Domain scores for 103 LactaMap original guidelines were above 75% in 3 of the 6 AGREE II quality Domains and no mean Domain score rated poorly. Update of guideline methodology was guided by phase 1 appraisals. Improved documentation of methods relating to questions in the Rigour of Development Domain resulted in improvement in mean Domain score from 39 to 72%. Conclusions This study showed that a theory-based approach to guideline development methodology can be readily integrated with a common-sense approach. Factors identified by AGREE II theory-based framework provided practical guidance for changes in methodology that were integrated prior to LactaMap website publication. Demonstration of high quality in LactaMap clinical practice guideline methodology ensures clinicians and the public can have trust that the content founded on them is robust, scientific and of highest possible quality.


1999 ◽  
Vol 13 (7) ◽  
pp. 560-562 ◽  
Author(s):  
Colin Macarthur ◽  
Liisa Jaakkimainen

The objective of this paper is to review the principles, methods and issues behind the development of clinical practice guidelines. Practice guidelines have been defined as “systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances”. The ultimate goal of guidelines is to improve patient outcomes; however, they may also be used as tools to decrease health care costs, improve medical education and enhance quality assurance. Evidence-based guidelines use explicit methods to link recommendations to the quality of the underlying research. Following development of the guideline, implementation and evaluation are key steps. The ultimate aim of guideline development is to influence physician knowledge, attitudes and behaviour.


2018 ◽  
Vol 103 (12) ◽  
pp. 4339-4342 ◽  
Author(s):  
Christopher R McCartney ◽  
Clifford J Rosen

Abstract An analysis of the Endocrine Society’s clinical practice guidelines (CPGs) published from 2010 to 2017—presented by Irwig et al. in the current issue of The Journal of Endocrinology and Metabolism—suggested that the Endocrine Society met five of seven National Academy of Medicine (NAM) standards concerning financial conflicts of interest in CPGs. As current contributors to the Endocrine Society’s CPG efforts, we offer additional context related to the 2011 NAM standards and the current environment concerning industry support in medicine, and we comment on the nature of industry support received by the Society’s CPG authors according to Irwig and colleagues’ analysis of the Centers for Medicare and Medicaid Services’ Open Payments database. Perhaps most importantly, we outline the Society’s recent and ongoing efforts to enhance the value of its CPGs. Such efforts include a 2016 revision of CPG author conflict of interest rules—a change that was invisible to the investigatory methods used by Irwig et al.—in addition to other processes designed to enhance CPG objectivity. We conclude our commentary by recognizing that good-faith attempts to enhance transparency and to reduce conflicts of interest (real or apparent) in CPGs will ultimately serve the best interests of patients and providers; we confirm the Endocrine Society’s resolute commitment to providing high-quality, evidence-based clinical guidance via a CPG development process that faithfully accords with current CPG best practices.


Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. J. Neuhaus ◽  
D. Thomas ◽  
J. Desai ◽  
C. Vuletich ◽  
J. von Dincklage ◽  
...  

In 2013 Australia introduced Wiki-based Clinical Practice Guidelines for the Management of Adult Onset Sarcoma. These guidelines utilized a customized MediaWiki software application for guideline development and are the first evidence-based guidelines for clinical management of sarcoma. This paper presents our experience with developing and implementing web-based interactive guidelines and reviews some of the challenges and lessons from adopting an evidence-based (rather than consensus-based) approach to clinical sarcoma guidelines. Digital guidelines can be easily updated with new evidence, continuously reviewed and widely disseminated. They provide an accessible method of enabling clinicians and consumers to access evidence-based clinical practice recommendations and, as evidenced by over 2000 views in the first four months after release, with 49% of those visits being from countries outside of Australia. The lessons learned have relevance to other rare cancers in addition to the international sarcoma community.


Sign in / Sign up

Export Citation Format

Share Document