Standards and Evidence-based Guidelines
Standards communicate expectations for how a health care worker should perform a particular health care activity. They define, for both health workers and clients, the ingredients needed to produce quality services and outcomes. Standards are thus the cornerstone of most health care improvement approaches, including accreditation and other forms of external quality evaluation, collaborative improvement, and process improvement.
There are different forms of standards, including: procedures, clinical practice guidelines, treatment protocols, critical paths, algorithms, standard operating procedures, or statements of expected health care outcomes.
National Health Care Waste Management GuidelinesZoomZoom
National Health Care Waste Management Guidelines, Swaziland
Standards are most effective if they are:
Regularly updated, communicated to providers, and are “evidence based”: In an evolving field such as health care – where new technologies, drugs, and procedures are continuously developed and an enormous body of scientific evidence is available to support clinical decision-making – it is critical to ensure that standards are regularly updated, communicated to providers, and are “evidence-based” to improve health care effectiveness and outcomes. Adherence to evidence-based standards is associated with improved health outcomes. Moreover, failure to provide clinical care in accordance with standards has serious negative effects on patient outcomes.
Clearly written, achievable, and available to health workers: Many areas of health care have international evidence-based standards, including standards adapted to low-resource settings. For example, the U.S. Government’s National Guideline Clearinghouse is a comprehensive, open-access database including over 2100 evidence-based diagnostic, surgical, and treatment guidelines, over 2000 disease or condition-related practice guidelines, and over 1400 drug-related guidelines.
Locally appropriate and reflect both the expected competencies of health care providers in that setting as well as the equipment, drugs, and supplies available to them. But even when locally appropriate, evidence-based standards exist, health workers may not follow them routinely.