National Academies Press: OpenBook

Clinical Practice Guidelines: Directions for a New Program (1990)

Chapter: NEXT STEPS FOR THE INSTITUTE OF MEDICINE

« Previous: EXPECTATIONS FOR PRACTICE GUIDELINES
Suggested Citation:"NEXT STEPS FOR THE INSTITUTE OF MEDICINE." Institute of Medicine. 1990. Clinical Practice Guidelines: Directions for a New Program. Washington, DC: The National Academies Press. doi: 10.17226/1626.
×
Page 17

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

SUMMARY 17 Attention to implementation and evaluation needs to be factored into the development process at an early stage. The Forum can underscore its intent to examine critically and improve its program and products in at least three ways. First, it should ask its expert panels for feedback on the strengths and weaknesses of the procedures followed. Second, it should pretest (or arrange for the pretesting of) all guidelines developed under its aegis. This can be done on a pilot basis in a real delivery setting, on a set of prototypical cases, or through both methods. Third, it should try to evaluate the effectiveness of intermediate actions (for example, formatting, dissemination, incentives) that are necessary if guidelines are to have their intended effects on health practices, outcomes, and costs. Each of these steps can be part of a learning process for the Forum and others. NEXT STEPS FOR THE INSTITUTE OF MEDICINE In May 1990, a new IOM committee began an 18-month study of the development, implementation, evaluation, and revision of clinical practice guidelines. Many of the issues raised in this report will be examined in depth during this second project, which is supported by the John A. Hartford Foundation, Inc., and the Public Health Service. In preparing its report and recommendations, the new committee will • describe existing initiatives to develop, implement, and evaluate practice guidelines; • identify the strengths and limitations of these efforts in light of the objectives and concerns of specific interest groups and society in general; • describe different models of public and private action that might serve as prototypes for better structuring activities related to guidelines; • analyze and assess the strengths, weaknesses, uncertainties, and trade-offs of different models in responding to identified problems and objectives; and • propose a framework for better structuring the development, implementation, evaluation, and revision of practice guidelines. In addition, the new committee will propose a practical methodology for AHCPR and others to employ in assessing guidelines before recommending or using them. It will focus on how the guidelines were developed, their scientific basis, their relevance to clinical practice, their clarity, and other characteristics. Such initial assessments will not substitute for later evaluations by government and others of the impact of a set of guidelines. The committee's recommendations will cover both government and private activities, and its report will identify legislative, management, and

Next: FINAL COMMENT »
Clinical Practice Guidelines: Directions for a New Program Get This Book
×
Buy Paperback | $50.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF
  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!