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Understanding and Using Evidence-Based Clinical Practice Guidelines

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There is an increased focus on providing evidence-based care in both the military and civilian health care systems. Since 1998, the Defense Department (DoD) and Department of Veterans Affairs (VA) have worked together to develop CPGs for treating psychological and physical health concerns. The departments’ working groups create the guidelines based, in part, on the readiness needs of service members and veterans.

The Institute of Medicine [PDF 511KB] defines clinical practice guidelines (CPGs) as “statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.”

CPGs create consistency of care. They can support provider and patient decisions about appropriate care for specific concerns but should not replace a provider’s best judgment.

Potential Benefits for Health Professionals

CPG use can lead to a number of advantages that positively affect both the providers and patients. If implemented correctly, CPGs can:

  • Improve quality of clinical decisions and care
  • Offer clear recommendations for providers
  • Promote efficient use of resources
  • Streamline access to resources

Implementation Process

Providers can implement CPGs by following the recommendations and algorithms provided in the specific guideline as close as possible for patient care and by adapting to meet the needs of your clinic. There are three stages of use [PDF 8.9MB]:

  1. Adoption: The first step is to adopt the CPG and ensure staff members commit to using it. Every staff member in your clinic may have a role to play in this process, so it’s important to educate staff about the necessary steps to implement each guideline.
  2. Implementation: Your practice should assess current clinical processes in place, identify areas of improvement and develop an implementation action plan. To help create the plan, consider using the process below:
    • Preparation and data collection – Collect basic medical information about your patients, how you treat them, how many you treat, and where you treat them. Use this information to compare your current practices with the key elements listed in the CPG.
    • Develop the implementation action plan – The steps in this process include:
      1. Analyze gaps between current practice process and the CPG
      2. Identify barriers to successful implementation
      3. Develop a strategy and action plan
      4. Choose metrics to evaluate and monitor progress
  3. Institutionalization: Once CPG steps are fully implemented in your practice, you can focus on maintaining quality of care. This includes measuring how well your clinic has maintained each element of the guideline implementation over time and making changes as needed.

Support Tools for Using CPGs

The Deployment Health Clinical Center has a number of clinical support tools to aid the use of CPGs. These tools include important resources that support evidence-based treatment across DoD and VA. Examples include:

  • Provider Reference Pocket Cards – These cards give recommendations on recognizing and managing specific conditions. An example is the suicide risk pocket guide [PDF 306.7KB].
  • Patient Education Guides – Clinic leaders and providers can use these guides to help their patient community understand concerns and learn support strategies. An example is the substance abuse brochure for families [PDF 1MB].

Access all VA and DoD psychological health CPGs through the VA website. CPGs and support tools are regularly updated as new research becomes available. Use them as a source of clinical practice information.

Additional Resources

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