Clinical Practice Guidelines (CPGs)
Clinical Practice Guidelines (CPGs) are based on best practices. Ideally, such a situation would imply that a need for monitoring of outcomes associated with the guidelines is not necessary because of their inclination toward best practice. Nonetheless, monitoring of the results remains a core pillar of the implementation. In this essay, an assessment of the rationale for the monitoring will occur.
In some situations, despite the implementation of practice guidelines, the performance of an intervention may still be below par. Such an occurrence does not necessarily imply that the applicable guideline is ineffective. Instead, it may mean that the local setting has major structural challenges that impede the efficient implementation of the guidelines (Fischer et al., 2016). Consequently, the monitoring of outcomes in such a situation would provide a platform for the management of the local setting to identify and address the existing structural barriers. Such a result would lead to an overall improvement in both the application of the clinical guidelines and functioning of a facility’s procedures and work systems.
Secondly, monitoring of outcomes may lead to the discovery of new evidence. The development of clinical guidelines does not imply that all the issues concerning a certain practice problem have been addressed — gaps concerning a particular intervention may still exist. Failure to establish measures for monitoring may create a situation where practitioners fail to detect the new evidence that may arise regarding the subsisting gaps. Moreover, it also provides the basis for identifying areas that may require improvement in subsequent rounds of research.
In conclusion, monitoring remains a critical part of the implementation process for CPGs despite their being based on best practice. It provides a basis for the improvement of existing guidelines. Therefore, as Fischer et al. (2016) contends, all clinical guidelines must incorporate evidence-based monitoring mechanisms.
Reference
Fischer, F., Lange, K., Klose, K., Greiner, W., & Kraemer, A. (2016). Barriers and Strategies in Guideline Implementation—A Scoping Review. Healthcare, 4(3), 36. https://doi.org/10.3390/healthcare4030036