Guideline developers are unlikely to be held liable for any negative consequences of the implementation of guidelines. In general, guidelines should be summaries of the evidence, should have an expiry date, should not be unduly prescriptive, and should acknowledge areas where there is disagreement. An independent review of the guideline development process is recommended.
Conclusions
The development, dissemination, implementation, evaluation and revision processes described in this document are applicable to a wide range of clinical interventions and disciplines and could also be applied to protocols relating to the use of technology and pharmaceuticals.
Where possible, it is preferable, to use existing networks, facilities and publications to disseminate, implement and evaluate guidelines, rather than developing new processes. A systems approach is needed, which builds guideline development, dissemination, implementation and evaluation into the routine processes of care. Organisations such as hospitals, health care regions, and divisions of general practice should establish an approach that integrates guidelines into their local health care delivery processes. Such an approach would involve sensible use of resources, developing sustainable infrastructure, integrating available resources and strategies, and adapting to local needs.
The best approach to making sure guidelines work would appear to be a mix of strategies that are suitable for local conditions and are developed in concert with local clinicians, consumers and managers.
This document will be revised. For those seeking further information, a series of specialised ‘tool kits’, currently being developed, will be available in mid-1999. Users and reviewers of these guidelines are encouraged to contact the National Health and Medical Research Council if they have comments—negative or positive—to make. These comments will inform the revision process.
Users can contact the National Health and Medical Research Council by writing to:
Health Advisory Unit Office of the National Health and Medical Research Council Department of Health and Aged Care GPO Box 9848 (MDP 50) CANBERRA ACT 2601