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CPG ADAPTATION METHODOLOGY

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CLINICAL PRACTICE GUIDELINES

Publicado en: Atención sanitaria
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CPG ADAPTATION METHODOLOGY

  1. 1. KNH Clinical Practice Guidelines Adaptation Methodology Jhessie L. Abella, RN, RM, MAN, CPSO, SMRIN
  2. 2. Clinical Practice Guidelines • Clinical guidelines are consensus statements developed to assist in clinical management decisions. • Are sponsored or supported by professional associations or societies, public or private organizations, government agencies, etc., and include evidence if modified to meet the population served • CPG’s are developed on the focus of quality, based on scientific evidence and the assessment of likely benefits and harms of a particular treatment
  3. 3. WHAT IS THE IMPORTANCE OF CPGs?
  4. 4. CPG’s guide practitioners with: Questions to ask and physical signs to check Lab and other studies to request Assessments of the condition Treatments to prescribe Improve healthcare decision making
  5. 5. HOW CAN WE INTEGRATE GUIDELINES IN OUR HOSPITAL SYSTEM?
  6. 6. Types of implementation tools used to integrate guidelines into daily practice and into the patient care system are:  Clinical pathways/critical pathway/care maps  Clinical protocols  Standardized order sets  Process flow charts These tools often include automatic triggers for care according to the guidelines
  7. 7. DO WE HAVE EXISTING CPGs in the
  8. 8. HOW DID WE PRIORITIZE OUR CLINICAL PRACTICE GUIDELINES?
  9. 9. Criteria for Choosing CPG at KNH  The prevalence of the condition and/or burden associated with the condition  Existence of underuse, overuse or misuse of interventions  The likelihood that the guideline will be effective in influencing practice  The existence of relevant good quality evidence-based guidelines
  10. 10. CRITERIA STROKE PERIPHERAL NEURITIS POLYNEUROPATHY MYTHEMIA GRAVIS The prevalence of the condition and/or burden associated with the condition 5 3 4 2 Existence of underuse, overuse or misuse of interventions 5 3 4 3 The likelihood that the guideline will be effective in influencing practice 5 4 3 4 The existence of relevant good quality evidence-based guidelines 5 5 5 4 SUM 20 15 16 13
  11. 11. DEVELOPED OR ADAPTED?
  12. 12. Guideline Adaptation • Guideline adaptation is the systematic approach to the endorsement and/or modification of a guideline(s) produced in one cultural and organizational setting for application in a different context. Adaptation may be used as an alternative to de novo guideline development, e.g., for customizing (an) existing guideline(s) to suit the local contents
  13. 13. ADAPTE Guideline Adaption  Is an international collaboration of researchers, guideline developers, and guideline implementers who aim to promote the development and use of CPGs through the adaptation of existing guidelines.  Our institutional CPG policy is solely based on this toolkit developed by ADAPTE collaboration.
  14. 14. ADAPTE - a systematic approach to guideline adaptation Why develop a systematic approach ?  Help ensure the quality and validity of the adapted guideline  Enhance relevance of adapted guideline to the context of use  Encourage confidence in and acceptance of the guidelines by targeted users
  15. 15. ADAPTE PROCESS
  16. 16. 18 Madrid - 30/11/2006 - B. Fervers. Copyright © 2006 www.adapte.org ADAPTE process  Target audience  Guideline developers, health care professionals and decision makers  Groups from local to international level  Manual takes into account level of experience with guideline development and available resources  Applications  Groups interested in selecting 1 cpg and adapting it to the local context  Groups wishing to identify all high quality guidelines and customize one that meets their needs  Manual designed to be flexible  Scope  CPGs of any disease area  Screening, diagnosis, treatment, supportive care, health promotion
  17. 17. THE SET UP PHASE
  18. 18. ADAPTATION PHASE
  19. 19. 21 Madrid - 30/11/2006 - B. Fervers. Copyright © 2006 www.adapte.org Adaptation Phase Scope and Purpose Module Patient population and disease characteristics Intervention (s) of interest Professionals targeted by the guideline Outcomes and endpoints to be taken into consideration Healthcare setting and context PIPOH
  20. 20. ADAPTATION PHASE
  21. 21. Appraisal of Guidelines Research & Evaluation (AGREE 2 INTRUMENT)  Was developed to address the issue of variability in guideline quality. To that end, the AGREE instrument is a tool that assesses the methodological rigour and transparency in which a guideline is developed.  Domain 1. Scope and Purpose  Domain 2. Stakeholder Involvement  Domain 3. Rigour of Development  Domain 4. Clarity of Presentation  Domain 5. Applicability  Domain 6. Editorial Independence
  22. 22. ASSESSMENT PHASE
  23. 23. ADAPATATION PHASE
  24. 24. ADAPATATION PHASE
  25. 25. FINALIZATION PHASE

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