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Adopting and adapting clinical guidelines for local use

^1. Scottish Programme for Clinical Effectiveness in Reproductive Health, Room 64, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZD, UK. Email: g.c.penney{at}abdn.ac.uk

Key content:

• Clinical guidelines help to standardise and improve patient care.
  
• Development of a valid clinical guideline requires resources and skills.
  
• Local adaptation of a national guideline provides a cost-effective approach to guideline introduction.
  
• A formal consensus process allows local stakeholders to adapt a national guideline.
  
• The adapted guideline combines the rigour of national development with the acceptability engendered by local consensus.
  

Learning objectives:

• To gain an overview of the fundamental principles of clinical guideline development.
  
• To learn how to adapt national guidelines for use by local NHS organisations or by groups of clinicians in non-UK settings.
  

Ethical issues:

• Guideline introduction diverts scarce resources from direct clinical care.
  
• Evidence indicates that guidelines result in only modest to moderate improvements in patient outcomes.
  
• Clinicians wishing to introduce clinical guidelines should adopt an approach that minimises resource use.
  

Please cite this article as: Penney GC. Adopting and adapting clinical guidelines for local use. The Obstetrician & Gynaecologist 2007;9:48–52.

Keywords clinical guidelines / decision making / evidence base