Our first speaker will be Renaud Abusawa. Renaud is a clinical pharmacy specialist at Rush University, and prior to that she was in Boston. She trained extensively in Florida and then moved to Boston and now in Chicago. Renaud has extensive experience in applying clinical practice guidelines in the clinics and facilitating their use in clinics. But today she will be talking about why clinical practice guidelines are important. Her entire biography is in the app if you choose to review. Thank you, Renaud. All right, thank you for that introduction and thank you all for being here. So I have the honor and pleasure of talking to you guys about why clinical guidelines are important. I have no disclosures relevant to this presentation. So how many of you in the audience, you could just raise your hands, have used a guideline today or in the past couple of days in some capacity? Right, so a good, I'm sure the majority of you in this room have used guidelines every day in terms of your day-to-day practice. So you all know the importance of guidelines. There, my talk is done, right? I can just go back down. No, I'm just kidding. So in all seriousness, clinical guidelines have become a fundamental part of medicine these days and these words that I've kind of included here on the slide have a essential place in our vocabulary. But that wasn't always the case. So we are going to be kind of looking into a little bit of history to kind of figure out where we were and where we are today to kind of answer this question of why clinical guidelines are important. So these terms are commonly used, but they're not with common agreement about their definitions. So in subsequent lectures in this session today, we'll be talking about these definitions in a little more detail. But I wanted to introduce the terminology so when we talk about the history, we can understand some of the differences. So guidelines as a term is very broad and it just is addressing broader systems. Clinical practice guidelines is related to clinical matters, although there is a more stringent definition that we'll talk about later. Protocols oftentimes in healthcare is essentially the application of those guidelines with very specific instructions for the particular process. And then care pathways are a series of evidence informed steps, typically with a multidisciplinary team at multiple various care levels of particular diagnoses. So they tend to be more specific than clinical practice guidelines, but they're oftentimes based on those. Okay, so I really like trivia. So does anyone know when guidelines, as we know them today, were first introduced? I'll take any guesses. Anybody a history buff here? 1984, so close. So it was actually in the 1970s. And it really depends on, this is kind of the overall history. So in the 1970s, the concept of experts coming together and forming an expert opinion was first developed. And then in the 1980s is probably more when we started getting this idea of evidence-based medicine. And then the 1990s, the Institute of Medicine actually put out guidelines to standardize guidelines, essentially. And we'll talk a little bit about that on the next slide. But essentially, they put out a definition, and I've included that here for you, where it's the systematically developed statements to assist the practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. And so this is a little more information from that Institute of Medicine report. So they pretty much essentially put out this report, and they said that guidelines need to include these things. So it has to be a systematic review of existing evidence. There has to be a knowledgeable multidisciplinary panel of experts and key affected groups. Patient subgroups and preferences need to be considered. And there has to be an explicit and transparent process of the guideline development that minimizes bias, distortion, and conflicts of interest. And then there had to be an explanation of alternative care options and health outcomes. And part of that last bullet really included the experts and the developers of that guideline had to report out the quality of evidence and the strength of the recommendations that they were making. And then of course, with any document such as this, and in healthcare, things are always changing, so there had to be a revision process as was warranted with new evidence. So for me, the progression of guidelines historically really just is a transition from something that's more opinion-based to something that's more evidence-based kind of big picture. And so it really shows us how we close the gap between what we do as clinicians and what the scientific evidence supports. So I won't be talking too much about this because on the next couple of slides, there will be much more information about these two topics. But one important part of clinical practice guidelines is their standardization and evaluation. And the grade and agree to are two, there are two processes that are a part of the clinical practice guideline development. Who cares, right? So clinicians, policy makers, and payers see guidelines as a tool for making care more consistent, efficient, and again, for closing that gap between what we do and what scientific evidence supports. I think as a healthcare professional, why I care and a lot of my colleagues care about guidelines is because we have an intrinsic desire to do the best for our patients. And in all of these institutions, the patient is kind of at the center of why we do what we do and as you'll see, why clinical practice guidelines are important. Okay, so a couple of things that are important when we consider the implementation of clinical practice guidelines to each of these kind of broad institutions. So for the patient, oftentimes it improves health outcomes. It improves quality of life. Ideally, it reduces morbidity and mortality. There's consistency in care between institutions. There's a shared decision making and it oftentimes will influence public policy and ideally helps bridge the gap in access of care to underserved or high-risk populations. For us as clinicians, it improves the quality of our clinical decisions and oftentimes adds support and validity to those. It allows us the opportunity to update our practice, again, provide consistency of care. It gives us that sense of validity and reassurance. It allows us to also do research, whether that's quality improvement or other forms of research and then there is a thought that it also has a medical, legal, or administrative protection in terms of liability as well. And of course, to the healthcare institution, they're always looking at efficiency and cost. So oftentimes, clinical practice guidelines can help with standardizing care and allowing for efficiency in the way we care for patients. It can optimize the value of that care for the money and the resources that are used. Decreasing hospitalizations, decreasing the use of unnecessary prescription medications, decreasing other treatment modalities such as surgery, and improving the public reputation, which is oftentimes important for institutions. And then that also oftentimes drives or allows for other forms of economic or political support. So I've included the definition of the clinical practice guideline here, mainly because I wanted to highlight a couple things. So at the core, these guidelines are recommendations that are intended to optimize patient care, are informed by a systematic review of evidence and, oops, and is an assessment of the patient benefits and harms of alternative care options. So this definition was actually the IOM update in 2011 of the definition of clinical practice guidelines. So again, the goal of clinical practice guidelines and the implementation of them is to optimize patient care. And really, what that looks like is, again, improving the consistency of care, empowering patients by employing a shared decision-making model, ultimately influencing public policy, developing disease performance measures and evaluations, and the use of high-value interventions. And so in order to balance healthcare quality and cost, there are three main things that we have to consider. So we want to use the best available evidence, we want to incorporate patient values and incorporate our clinical expertise. Oh, sorry about that, that image did not show up, but that's okay. So just a couple of key takeaways that I want you guys to take away from this presentation is that clinical practice guidelines are the mainstay of healthcare education and practice. The goal is to standardize and optimize patient care, but that being said, they still are guidelines, and so I think there's going to be a speaker who's going to delve into that a little more. But I always say they are an arsenal and are a tool of clinical decision-making for our patients. Okay, so why are guidelines important? Oops, so it's still early in the session, so I hope this doesn't put anyone to sleep, but I invite you guys to close your eyes and think about that one, or a few, or all of the patients that you've had the honor of taking care of. Those patients are why clinical guidelines, I believe, are important. Thank you.

clinical practice guidelines

evidence-based medicine

patient care

healthcare policy

decision-making