Involve the Entire Cancer Care Team to Effectively Implement Guidelines
Only 19% of strategies to implement clinical practice guidelines are fully effective and the majority (43%) are not effective at all, according to the findings from a clinical review (https://doi.org/10.1016/j.healthpol.2012.08.005) in the European Union. Effective guideline implementation (https://doi.org/10.1136/practneurol-2017-001814) requires teamwork, interprofessional engagement, and selecting the most appropriate tool for the job.
Through the Practice Guidelines Implementation Network (https://www.asco.org/research-guidelines/quality-guidelines/practice-guidelines-implementation-network-pgin) (PGIN), the American Society of Clinical Oncology connects more than 100 ASCO volunteers to assist in guideline development, review, dissemination, and implementation through their individual networks and peer exchange. The volunteers are recruited through ASCO and state oncology societies and include oncologists in community and academic settings, other disease site content experts with an interprofessional focus on medical, pediatric, surgical, and radiation oncology, oncology nurses, hematology/oncology pharmacists, oncology practice managers, and other related healthcare providers.
Through the network, PGIN members (https://www.asco.org/research-guidelines/quality-guidelines/practice-guidelines-implementation-network-pgin):
- Sit on expert panels that develop guidelines, the clinical practice guidelines committee, and guideline advisory groups.
- Provide input on implementing guideline recommendations.
- Encourage guideline panels to discuss practice issues that could affect the application of recommendations.
- Review and revise ASCO guideline implementation tools or suggest new ones.
- Serve as ambassadors to share ASCO guidelines and implementation tools with peers and state and other specialty societies.
A comprehensive, interprofessional approach to oncology guideline dissemination and implementation is essential for delivering state-of-the-science care to patients with cancer, and oncology nurses are invaluable in that work to achieve safe and effective clinical outcomes for patients.
Some of the barriers to guideline implementation include user learning styles and providing guidance at the point of care. To address those challenges, clinicians can access the guidelines in a variety of formats, all at asco.org/guidelines:
- Algorithms
- Flow diagrams
- Patient information
- Pocket cards
- Recommendations tables
- Slides sets
- Visual abstracts
PGIN members co-chairing guideline expert panels and other expert members discuss guideline recommendations and their impact on clinical practice in the ASCO Guidelines podcast series (http://asco.org/about-asco/asco-digital/podcasts). Guidelines are also available in an app (http://asco.org/about-asco/asco-digital/apps) that houses expert recommendations, algorithms, and calculators that clinicians can access at the point of care.