Background: In order to realise the national and international standards of accreditation, the clinical practice guidelines (CPGs) Program at KSUMC was launched as a quality improvement collaborative project with Bahamdan Research Chair for Evidence-Based Health Care and Knowledge Translation in 2009.
Objectives: A fast-track method was needed to develop evidence-based CPGs at KSUMC
Methods: Following a guidelines-awareness week directed to all healthcare professionals (HCPs) in 2010, 20 multidisciplinary teams were developed. They were trained to set priorities, search, screen, assess, select and customise the best-available CPGs technically supported by the programme’s steering committee. The ADAPTE framework was the main reference used with highlights on other G-I-N resources. Due to the limited number of systematic reviewers, a modified way of handling the recommendations was used. Moreover, new tools to support the adaptation process were designed. A strict peer-review process was used for content and methodology.
Results: In addition to raising awareness and building capacity, 29 CPGs were approved by February 2017 with 10 more in progress. A new tool relating to identifying priority topics was developed (Appendix 1) and 3 existing ADAPTE tools were modified (Appendices 2 - 4). The AGREE-II tool was used instead & specific implementation tools were suggested in certain CPGs.
The 29 CPGs were integrated with other existing projects (e.g. EMRs, performance management system, residency training). Preliminary implementation data suggest positive impact on patient outcomes (e.g. LOS, prescribing of antibiotics, etc.). Leadership commitment was a strength but the high turnover of team members necessitated frequent training of HCPs.
Conclusions: The ADAPTE Framework has repeatedly proven to be the working prototype for CPG adaptation allowing for modifications in different contexts. This modified version represents a quick, practical, economic method with a sense of ownership by staff. It should be replicated in other countries to assess its validity. This could inform the update of the next ADAPTE resource toolkit and other regional CPG programmes.