Clinical guidelines are an important example of facilitation in medical care.
Guidelines may be developed by national consensus panels of experts (e.g., the US Preventive Services Task Force; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure), or more local groups. By methodically reviewing the evidence and recommending optimal strategies, these guidelines attempt to reduce practice variation and ensure widespread application of evidence-based care.
Unfortunately, studies have shown adherence to a major set of guidelines is only about 30% two years after publication. Guidelines often meet resistance from the people most involved in implementing them.
- What reasons can you think of for difficulty implementing new guidelines? What strategies might help to overcome these barriers?
- A health system choosing to establish standard care paths or guidelines for specific diagnoses can do much to reduce the likelihood of errors. How can guidelines help to simplify, differentiate, and adjust to facilitate appropriate care?