American College of Chest Physicians (ACCP) Health and Science Policy Committee

1. American College of Chest Physicians (ACCP) Health and Science Policy Committee Orientation Program Part #5 Review, Publication, and Implementation of Guidelines

2. Development of an Evidence-Based Guideline Review process commences NetWorks comment Health and Science Policy Peer Review • NetWorks appropriate to the clinical topic are selected for review of the guideline • NetWork members are appointed to read the document from cover-to-cover and submit comments to the HSP Committee on behalf of the NetWork • At the same time, the document reviewed by the Guidelines Subcommittee and the entire HSP Committee for review and conditional approval • The HSP Liaison appointed to the guideline panel is required to read the document from cover-to-cover • Other HSP members are appointed to read individual sections or chapters

3. Development of an Evidence-Based Guideline Review process commences NetWorks Peer Review Health and Science Policy Peer Review Board of Regents Peer Review ACCP Journal CHEST Peer Review • The Board of Regents and the CHEST journal review guidelines under their own process and are not under the purview of HSP

4. ACCP Partnerships with Other Organizations

5. Development of an Evidence-Based Guideline Publication HSP produces 1-3 evidence-based clinical practice guidelines per year on average. Larger guidelines appear as supplements to the monthly issue of CHEST, while others are published in the journal. Current subscribers (about 23,000) receive all CPGs. Guidelines are also available: • Electronically on ACCP Web site • On the National Guidelines Clearinghouse Web site • PDA downloadable from ACCP Web site • Presentations at CHEST and other meetings

6. Development of an Evidence-Based Guideline Development of other products Clinical Resource The Clinical Resource is a dissemination toolkit which includes a Quick Reference Guide (QRG), POWERPoint slide sets, Patient Education materials, and additional resources for healthcare providers and their patients.

7. Dissemination versus Implementation Improved patient care requires the integration of patient values, clinical expertise,and the best evidence distilled within the guideline. Successful guideline integration comprises an important component in the ACCP’s endeavors to provide “patient focused care.” Development of guidelines does not by itself ensure that the recommendations will be followed. Disseminating or circulating guidelines to practicing physicians is a necessary but not a sufficient component in the process.

8. Dissemination versus Implementation Implementation differs from dissemination although the two terms are often intertwined. Where dissemination deals with providing the information to end users by many means (eg, publication, sales, internet access, etc), implementation focuses on incorporating the recommendations into clinical practice to facilitate change and improve health care. Implementation involves the physician and patient making shared decisions based on evidence provided in the practice guidelines. The HSP Committee’s Subcommittee on Implementation is focusing on these efforts.

9. Dissemination of the Clinical Resource The Clinical Resource is provided to select subgroups or NetWorks with ACCP and sold to other members and nonmembers. • Vehicles for advertising the Clinical Resource include: • Ads in CHEST • Ads and articles in CHEST Physician • Newsletters of other endorsing or interested organizations • Promotions at CHEST and other conferences • Marketing to attendees at ACCP courses and programs.

10. Beyond Dissemination Effective guideline utilization goes far beyond publication and distribution. The Health and Science Policy Committee is participating with other organizations in the development of quality tools and performance measures. This evolving process is only in its infancy but ACCP guidelines can serve as the building blocks for current and future implementation efforts. Performance measures are tools to support physicians in their efforts to enhance the quality of patient care. These measures are developed for physicians by physicians and are based on recommendations contained in evidence-based clinical practice guidelines. Performance measures can be used by individuals to monitor their quality improvement efforts and track data from their own practice.