Clinical Practice Guidelines Unit, Quality Management Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Research Chair for Evidence-Based Health Care and Knowledge Translation, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.
J Eval Clin Pract. 2019 Aug;25(4):550-560. doi: 10.1111/jep.12927. Epub 2018 Apr 24.
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program.
Twenty-two clinical departments participated in the program. Following a CPGs awareness week directed to all health care professionals (HCPs), 22 teams were trained to set priorities, search, screen, assess, select, and customize the best available CPGs. The teams were technically supported by the program's CPG advisors. To address the local health care context, a modified version of the ADAPTE was used where recommendations were either accepted or rejected but not changed. A strict peer-review process for clinical content and methodology was employed.
In addition to raising awareness and building capacity, 35 CPGs were approved for implementation by March 2018. These CPGs were integrated with other existing projects such as accreditation, electronic medical records, performance management, and training and education. Preliminary implementation audits suggest a positive impact on patient outcomes. Leadership commitment was a strength, but the high turnover of the team members required frequent and extensive training for HCPs.
This model for CPG adaptation represents a quick, practical, economical method with a sense of ownership by staff. Using this modified version can be replicated in other countries to assess its validity.
背景、目的和目标：临床实践指南（CPG）是循证医疗质量改进的重要工具。沙特国王大学的 CPG 项目作为一个质量改进项目启动，以满足国际认证标准。该项目是循证医疗保健和知识转化研究主席与质量管理部门之间的合作。本研究旨在开发一种快速适应循证 CPG 的方法，并描述该计划的结果。
22 个临床科室参与了该计划。在向所有医疗保健专业人员（HCP）开展为期一周的 CPG 意识周活动后，培训了 22 个团队来确定优先事项、搜索、筛选、评估、选择和定制最佳可用的 CPG。该团队得到了该计划 CPG 顾问的技术支持。为了解决当地医疗保健环境的问题，使用了经过修改的 ADAPTE 版本，其中建议要么被接受，要么被拒绝，但不进行修改。对临床内容和方法进行了严格的同行评审。
除了提高认识和能力建设外，截至 2018 年 3 月，已有 35 项 CPG 获得批准实施。这些 CPG 与其他现有项目（如认证、电子病历、绩效管理以及培训和教育）相结合。初步的实施审计表明对患者结果产生了积极影响。领导层的承诺是一个优势，但团队成员的高更替率需要对 HCP 进行频繁和广泛的培训。
这种 CPG 适应模式代表了一种快速、实用、经济的方法，具有员工的归属感。使用这种经过修改的版本可以在其他国家进行复制，以评估其有效性。
