A pragmatic model for evidence‐based guideline development in hospitals

Existing methods of development of evidence‐based guidelines are time‐consuming, resource‐intensive and require extensive skills in systematic reviewing. These factors act as barriers to development of evidence‐based guidelines in hospitals. The aim of this paper is to revise the existing method of development of evidence‐based guidelines to create a new pragmatic model that was feasible in hospital settings.

The model consists of eight steps: scope, prioritise, search, appraise, draft, consult, disseminate and update. These steps largely parallel the established guideline development process, but suggest more focused, pragmatic methods.

The “prioritise” step is a new step. Other differences include: guideline development by an individual or small group rather than a large multidisciplinary group; searching for evidence for only a limited number of priority decision points rather than for all decision points; searching only in a limited number of sources likely to provide high quality research rather than searching very broadly; searching only for high‐quality research which is less open to bias rather than searching for all forms of research evidence; including only research evidence which can be easily accessed in full text, rather than investing time in tracking down research which is difficult to obtain; and only involving consumers in guideline development where an existing mechanism for consumer involvement exists.

This new, pragmatic guideline development model aims to overcome the substantial barriers to guideline development in hospital settings. This model needs to be tested to determine if it is feasible and produces guidelines that are trustworthy.