Clinical practice guidelines are systematically developed statements to assist practitioners and patient make decisions about appropriate health care for one or more specific clinical circumstances. Clinical practice guidelines are increasingly used in routine health care service delivery as means of improving the quality and safety of health care practices.
Another driver for development and implementation of guidelines has been the move towards Evidence Based Practice (EBP). While there are numerous variations of EBP definition, it is widely agreed EBP constitutes three key elements. EBP is the integration of best available evidence, with clinician's expertise and patient's morals, values and beliefs. Clinical guidelines provide clinicians with the access to synthesised best available research evidence derived using systematic and rigorous process.
While clinical practice guidelines have been used in health care for a long time, increasingly the processes of development of clinical practice guidelines have become more rigorous and transparent. This was in response to noticeable, and at times hidden, bias among developers of clinical practice guidelines. This bias often lead to statements and recommendations being made to support personal views of the developers rather than statements and recommendations formulated based on best evidence.
In order to address these issues in guideline development, current best practice in guideline development mandates transparency, rigour and reproducibility in the guideline development process. Guideline development is a highly technical and skilled process and increasingly there are specialised teams around the world who are considered to be expert guideline developers.
Clinical Practice Guidelines, Clinical Pathway, Practice Protocol?
While the importance of clinical guidelines are widely well recognized, there continues to be ongoing confusion with regards to terminologies used to describe various forms of evidence based tools to inform clinical practice. Often the term "clinical guideline" may be interchangeably used with "clinical pathway", "practical protocol" and "practice points". While all these tools aim to standardize clinical practice, and thereby improve processes and outcomes of care, they are all uniquely different. The below table provides an overview of clinical guideline, clinical pathway and practice protocol.
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