|Organisation sharing the GOP||
Related practices from PaSQ database
|Agency for Quality in Medicine (AQuMed)||
|Clinical guidelines or pathways
|Education in Patient Safety
|NDMGs are to be implemented in ambulatory care, hospitals and longterm care. The settings depend on the individual guideline, however primary care is a major focus as the guidelines target prevalent chronic diseases.
The guidelines are meant to be implemented as widely as possible in these facilities; implementation is voluntary.
|To promote effective delivery of health and disability services within the framework of disease management in Germany, based on best available evidence from research and practice.|
|Clinicians working in the health care sector (physicians, nurses, therapists), patients and their families, health care adminstrators, general public|
|The development and maintenance of the guidelines are coordinated by AquMed in collaboration with the Guidelines Commission of the Association of the Scientific Medical Societies in Germany. The individual guideline groups are further made up of experts from the relevant scientific medical societies, experts representing other professional groups (nurses, pharmacists, physiotherapists etc) and patient representatives.
Process steps in the development of an NDMG are:
|Average timeframe for guideline development: 3,5 years|
|Implementation tools available|
|For each guideline the following implementation tools are developed:
– short version & pocket version
– patient version (“patient guideline”)
– supplementary tools (e.g. checklists)
– quality indicators which are developed from the guideline’s recommendations
– software app
– CME based on the guideline
|Duration and costs of NDMG development process:
Example: NDMG for Diabetic Neuropathy in Adults
Example: NDMG for Heart Failure
|Method used to measure the results|
|The most important components of the evaluation process are guideline-based quality indicators. Suitable quality indicators are derived by AquMed from the NDMG recommendations in collaboration with experts. The use of the indicators to evaluate adherence to the guidelines and an improvement of patient outcomes e.g. within Disease Management Programmes or the German nation-wide quality assurance programme (e.g. hospital-benchmarking system) is encouraged.
Until now the evaluation of the NDMGs has not been in the direct scope of responsibilities of AquMed but projects to evaluate some of the NDMGs regionally by AquMed are in planning .
|Results from the evaluation of ambulatory Disease Management Programs, which integrate the recommendations from NDMGs, have shown positive results in terms of changes in medical outcomes (Stock et al. The Commonwealth Fund 2011;24(1560)).|
|Analysis of the results|
|Generally studies have shown that evidence-based clinical guidelines can be effective in improving the process and structure of care. The effects of guidelines on health outcomes have been studied less and data are less convincing (Lugtenberg et al. Qual Saf Health Care 2009;18:385–392)|
|Did you find implementation barriers?|
|Please describe implementation barriers|
|A barrier in the development process is that it is often difficult to reach consensus when formulating recommendations and this can delay the development of a guideline.
The development and maintenance of a clinical guideline are resource-intensive (esp. staff costs for the coordinating institution).
A further barrier to implementation is that there are still scepticism and limited acceptance in the medical community about clinical practice guidelines.
|Describe the strategies used to overcome the barriers (If needed)|
|Raising awareness about the importance of guidelines and capacity building in evidence-based medicine.|
|Other information about the GOP that you would like to add (Link or attached document)|