Anais de Evento

Adaptation of clinical practice guidelines for healthcare facilities: a rapid framework

REGINA KUHMMER, LUIZ CARLOS MARQUES PALLARES, KARINE MARGARITES LIMA, MAICON FALAVIGNA, FABIANO BARRIONUEVO, CATIA MOREIRA GUTERRES, GISELE ALSINA NADER BASTOS, GABRIEL DALLA COSTA, RODRIGO ANTONINI RIBEIRO, LUCIANO SERPA HAMMES

Em: G-I-N Conference, 2015, Amsterdan, v. 0, n. 0, p. 0-0.

Motivo: Produção Colaborador HMV

Setor HMV: Clínica Médica

Área da saúde: Clinica Medica

Resumo: Background: An increasing number of hospitals are developing clinical practice guidelines (CPGs), aiming standardization of processes. Guidelines should be specific for these settings to allow adequate implementation. Many hospitals do not have expertise in guideline development; as result, recommendations often are opinion-based instead of evidence-based. Context: In a project sponsored by Brazilian Ministry of Health (PROADI-SUS), we provided methodological support for rapid development of CPGs for a public hospital. Description of best practice: We developed three CPGs (asthma, community acquired pneumonia and rhinosinusitis) from October 2014 to November 2014. Documents were adapted from guidelines of a private nonprofit hospital, which has a structured guideline program since 2010. First, we abstracted the recommendations from the original CPGs. In an iterative process, we asked professionals (five to seven clinicians and managers from the target hospital) to provide written comments on recommendations, regarding potential barriers for implementation (e.g. availability of resources in their setting). When technical issues were raised, we limited the evidence search to DynaMed and UpToDate databases. After each iteration, we rephrased the recommendations and returned to the group. We reached consensus after three iterations for all CPGs. Lessons for guideline developers, adapters, implementers and/or users: Although the framework presented may be criticized due to lack of methodological rigor compared to other alternatives, such as ADAPTE and PGEAC, we achieved the aim of developing guidelines for a specific healthcare facility, with shortened timeframe and limited resources. To ensure trustworthy recommendations, is important to choose high quality and updated guidelines for adaptation.

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