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A Process for Selection of Clinical Practice Guidelines

A Process for Selection of Clinical Practice Guidelines by MGO's Quality Enhancement Committee

Introduction

Standards of care are necessary for the development and continuing progression of a clinically integrated entity.  Those standards of care are best defined by the use of clinical practice guidelines and will be developed, maintained, and communicated by MGO's Quality Enhancement Committee. The essential priority of providing standards of care for MGO patients is best met by utilizing clinical practice guidelines, realizing that the tool of practice guidelines is not applicable to all patients in all circumstances.


Development

Guidelines exist for many clinical entities.  Those guidelines that are most appropriate for MGO physicians need to be developed in a standardized fashion.  At the same time, guidelines must be appropriate for our purposes and must reflect our diverse physician membership.

Multiple guidelines have already been developed by multiple physician organizations.   MGO and its committees need not redevelop a new product for each guideline, but will review existing guidelines and adapt those for MGO.  This approach will simplify the task, will be consistent with evidence based efforts elsewhere, and will allow for adaptation to our local physician population.

 Principles

Adaptation of clinical practice guidelines for our use will need to be accomplished in a standardized and orderly fashion.  Creation of “new” guidelines from the existing aggregation of the hodge-podge of multiple current guidelines with variable reliability is a difficult task. Certain principles will need to be followed for this process to proceed in an orderly fashion.

 
Characteristics of the guidelines:  Guidelines will all need to share certain characteristics.  These characteristics have been well developed in other literature and will serve as guiding documents for MGO (see following).
 
           Timely Development: Guidelines will be developed over pre-determined time frames.  The time frames will 
            be outlined by the physician staff leadership of MGO based on the urgency for development.
 
            Procedures:  Pre-existing guidelines will be reviewed by selected work groups of physicians developed for that 
            unique purpose.  After consensus is obtained by the work group, the guideline will be shared with all members of
            MGO for a finite period of time to receive feedback. The project team will re-convene and finalize their
            recommendation  to the QE committee for final approval. 

           Review:  Because of the continuing changes in the practice of Medicine, a regular review mechanism is needed for
           accepted guidelines.  Reviews will occur on a generally accepted schedule, generally 24 months, but modifiable
           depending upon the particular guideline.

 
          Communication:  Distribution  of MGO guidelines to  the general membership of MGO will occur after 
           approval by the QE committee.  This communication will be both written and electronic (MGO website).

                  

                            


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