Using GRADE to engage healthcare professionals and managers in shared learning and collaborative development and implementation of local guidelines




Poster session 4 Saturday: Evidence implementation and evaluation


Saturday 16 September 2017 - 12:30 to 14:00


All authors in correct order:

Valacio R1, Costa A2, Paixão L3, Coelho R1, Marcolino M4
1 Hospital Municipal Odilon Behrens, Brazil
2 Hospital das Clínicas da Universidade Federal de M.G., Brazil
3 Hospital João XXIII, Fundação Hospitalar de MG, Brazil
4 Universidade Federal de Minas Gerais, Brazil
Presenting author and contact person

Presenting author:

Reginaldo Valacio

Contact person:

Abstract text
Background: Competency-based education and training (CBET) is essential to promote evidence-based practice (EBP). It encompasses knowledge conjoined with skills in communication, collaboration, leadership and health advocacy. GRADE methodology regards knowledge (evidence) as essential, but insufficient to guide decisions and values transparency highly. This may enhance partnerships among those involved in CBET, local managers and healthcare teams.

Objectives: To describe our experience on the use of GRADE to build capacity, enhance networking and promote collaborative EBP dissemination and implementation.

Methods: Professionals from several healthcare institutions from Belo Horizonte, Brazil, attended regular EBP courses and workshops, initially planned as part of medical residents’ CBET programme. Participants’ efforts to disseminate EBP created a good impression and gained support from hospital directors and municipality managers. Working groups (WG) were formed to present summaries of findings about specific interventions to multi-professional panels (MPP), using GRADE. Informed by evidence, MPP integrate patients’ values and preferences, local context and cost to develop local recommendations and agree on priorities for implementation. Participants will develop a consensus on barriers and facilitators to the initiative using Delphi Technique and will measure changes in clinical practice.

Results: More than 200 participants from 5 hospitals and 9 pre-hospital units from a city with more than 1.5 million inhabitants are involved, including managers, healthcare professionals and medical students. Four WGs use GRADE to disseminate recommendations, in the pursuit of effects to benefit patients. Local protocols are increasingly regarded as a common property that results from a collaborative effort and leads to common responsibilities, rather than documents or sources of information.

Conclusions: GRADE methodology facilitates the development of learning competencies, leadership and collaboration in EBP. This may avoid waste of efforts and human resources, as teaching experiences become opportunities for the development of healthcare networks.