Implementation overview

Ensuring the use of KHA-CARI Guidelines in clinical practice

Guidelines are an important aspect of quality patient care. They provide clinicians with recommendations that help them to practice evidence based medicine. The overall purpose of clinical guidelines is to improve health outcomes and to encourage the appropriate use of resources.

Guidelines are static entities if not put into practice. It takes a motivated team to change practice and incorporate a guideline into daily patient care. An essential part of the guideline development process is the formulation of a dissemination and implementation strategy.

KHA-CARI Guidelines staff has been and are continuing to research the best methods for ensuring the use of guidelines in clinical practice. Implementation projects are undertaken to assess both the impact of KHA-CARI Guidelines on clinical practice as well as the barriers faced by renal units in the implementation of KHA-CARI Guidelines. As implementation projects progress, KHA-CARI will develop tools to assist in guideline implementation.

Criteria used to identify which recommendations should be actively implemented include:

  • the presence of a strong evidence base supporting the recommendation
  • clinical importance
  • existence of a clear evidence/practice gap
  • patient burden of disease is high
  • ability to measure a change in practice
  • feasibility of development of an implementation strategy

Implementation projects are generally conducted according to three prime steps namely:

  • Phase I: Establish current practices and protocols
  • Phase II: Conduct implementation trial
  • Report findings