Relevance and meaning of Relevance and meaning of Guidelines in clinical practiceGuidelines in clinical practice

“Guidelines which changed the practice in anesthesia or will change in the next

future”ESA & SIAARTI Task force

Maurizio SolcaMaurizio SolcaA.O. MelegnanoA.O. Melegnano

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Guidelines in clinical practiceGuidelines in clinical practice

Clinical guidelines are recommendations by … on the appropriate treatment and care of people with specific diseases and conditions…They are based on the best available evidence.While clinical guidelines help health professionals in their work, they do NOT replace their knowledge and skills

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Guidelines in clinical practiceGuidelines in clinical practice

Good clinical guidelines aim to improve the quality of healthcare.They can change the process of healthcare and improve people's chances of getting as well as possible.

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Clinical guidelines can:

• provide recommendations for the treatment and care of people by health professionals

• be used to develop standards to assess the clinical practice of individual health professionals

• be used in the education and training of health professionals

• help patients to make informed decisions • improve communication between patient and

health professional

ESA GuidelinesESA Guidelines

• In 2007 ESA Council adressed the need of european In 2007 ESA Council adressed the need of european guidelines on a variety of aspects of anaesthesiologyguidelines on a variety of aspects of anaesthesiology

• This need was particularly felt in the countries This need was particularly felt in the countries technologically and economically disadvantagedtechnologically and economically disadvantaged

• At the Munich’s Euroanaesthesia Meeting the ESA At the Munich’s Euroanaesthesia Meeting the ESA Board accepted the Council proposal of establishing a Board accepted the Council proposal of establishing a Guidelines CommitteeGuidelines Committee

• This convened the first time in 2008, with the purpose This convened the first time in 2008, with the purpose of setting up the policies for drawing ESA Guidelines, of setting up the policies for drawing ESA Guidelines, and define the topics to developand define the topics to develop

Benefits of ESA Guidelines

• To make available European guidelines to be To make available European guidelines to be used by individual ESA members and used by individual ESA members and adopted, with any desired modifications, by adopted, with any desired modifications, by National Societies of Anaesthesiology for National Societies of Anaesthesiology for their own national use, if they so wish.their own national use, if they so wish.

• Harmonisation of clinical management of Harmonisation of clinical management of anaesthesiology, perioperative medicine and anaesthesiology, perioperative medicine and related clinical areas throughout Europerelated clinical areas throughout Europe

• Improvement of standards of care Improvement of standards of care throughout Europethroughout Europe

ESA GuidelinesESA Guidelines

• Collection of available guidelines from different Collection of available guidelines from different countries throughout Europe (and outside)countries throughout Europe (and outside)

• Each Scientific Subcommittee was requested to Each Scientific Subcommittee was requested to list a number of topics in which the need of a new list a number of topics in which the need of a new european guideline was felt to be the greatesteuropean guideline was felt to be the greatest

• The topics were ranked according to the The topics were ranked according to the frequency of citation, and three topics were frequency of citation, and three topics were selectedselected

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Eur J Anaesthesiol 2010;27:999–1015Published online 1 October 2010

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Eur J Anaesthesiol 2011;28:556–569Published online 28 June 2011

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Eur J Anaesthesiol 2011;28:684–722Published online 14 September 2011

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Conclusions

• Good guidelines help the individual clinician in making more educated decisions in her/his practice

• Guidelines are potent tools to improve care of patients

• Guidelines are NOT intended to replace clinical skill and wise judgement

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