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OCR for page 149
Appendix C
Next Steps for the Institute of Medicine
In May 1990, a new committee of the Institute of Medicine (IOM)
began an Month study of the development, implementation, evaluation,
and revision of clinical practice guidelines. The report will cover both
public- and pnvate-sector activities.
Many of the issues raised by the IOM Committee to Advise the Public
Health Service on Clinical Practice Guidelines will be examined in depth
during this second project. In preparing its report and recommendations,
the new committee will
.
describe existing initiatives to develop, implement, and evaluate
practice guidelines;
identify the strengths and limitations of these efforts ~ light of the
objectives and concerns of specific interest groups and society in general;
o describe different models of public and private action that might
serve as prototypes for better structuring activities related to guidelines;
.
analyze and assess the strengths, wealmesses, uncertainties, arid
trade-offs of different models in responding to identified problems and
objectives; and
.
propose a framework for better structuring the development, im-
plementation, evaluation, and revision of practice guidelines.
In addition, the committee will propose a practical methodology for
AHCPR and others to employ in assessing guidelines before recommending
or using them. This methodology will focus on the process by which the
guidelines were developed, their scientific basis, their relevance to clinical
149
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150
CONICAL PRACTICE GUIDELINES
practice, their Claris, and other characteristics. Such initial assessments
will not substitute for later evaluations by government and others of the
impact of guidelines.
I-he committee's recommendations will identify legislative, manage-
ment, and other steps necessary to implement the recommendations. That
is, the design plan will propose, insofar as possible, both what to do and
how to do it. An active program of disseminating the committee's findings
and recommendations is planned. This next project on practice guidelines
is supported by grants from the John ~ Hartford Foundation, Inc., and the
Public Health Service. The committee is chaired by Jerome H. Grossman,
and the study director is Marilyn J. Field. The report should be released
in the fall of 1991.
Representative terms from entire chapter:
clinical practice
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