Setting Priorities for Clinical Practice Guidelines (CPGs) in the Emergency Department of a Teaching Hospital

Design, localization and implementation of Clinical Practice Guidelines (CPGs) is a time consuming and costly task. Hence, it seems necessary to set some priorities for different CPGs.This cross-sectional study was conducted in the year 2012 in Imam Hossein Hospital. All emergency medicine specialists participated in this study. The data collection instrument was a questionnaire consisting of two parts. The first part of the questionnaire consisted of 41 effective criteria in prioritization, design and localization of clinical practice guidelines (CPGs) covering ten major fields, meanwhile the second part contained a list of diseases/conditions prevalent in the emergency department. Given the importance of each issue and the need to prioritize the design and development of clinical practice guidelines for given disease/condition, a score of one to nine (the least important to the most important) was assigned to each of the effective fields. The data was analyzed using SPSS, Ver. 18 and the level of statistical significance was considered to be p <0.05. Among effective ten fields in identifying and prioritizing the diseases and conditions that required design and development of clinical practice guidelines, high effectiveness potential of such guidelines had the utmost importance and influence in the opinions of the experts. The most important priorities for preparing clinical practice guidelines were identified as the followings: Acute coronary syndrome (ACS) and seizure in terms of high burden of the diseases, ACS regarding information requirements in health care sector, ACS and seizure with respect to feasibility, pulmonary embolism (PE) and spinal injuries as the first priority in terms of effectiveness, ACS and stroke as the most important priorities in terms of economic impacts on the health care system, procedural sedation and analgesia (PSA) in terms of heterogeneity of treatment, ACS, as the first priority in terms of social impacts/justice, orthopedic trauma in terms of consumers' preferences, ACS in terms of adverse events, ACS regarding disease prevention and health promotion and finally ACS as the first priority covering all such fields. Given the need for rapid intervention in the case of admission of the emergency patients and the emergency events, design, development and implementation of clinical practice guidelines in this section provides uniformity for practices of the physicians and makes it easier to predict the future needs and requirements. By implementation of and acting in accordance with the clinical practice guidelines, financial and human resources of the health care system may be saved and resources can be redirected to the fields in dire need.