Maternal and perinatal guideline development in hospitals in South East Asia: the experience of the SEA-ORCHID project
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BioMed Central
Open Access
Research
Maternal and perinatal guideline development in hospitals in South East Asia: the experience of the SEA-ORCHID project Tari J Turner*1, Jacki Short2 for The SEA-ORCHID Study Group Address: 1Monash Institute of Health Services Research, Monash University, Monash Medical Centre, Clayton, Victoria, Australia and 2Perinatal Services Network, University of Sydney, Sydney, NSW, Australia Email: Tari J Turner* - [email protected]; Jacki Short - [email protected]; The SEA-ORCHID Study Group - [email protected] * Corresponding author
Published: 8 May 2009 Health Research Policy and Systems 2009, 7:10
doi:10.1186/1478-4505-7-10
Received: 23 January 2009 Accepted: 8 May 2009
This article is available from: http://www.health-policy-systems.com/content/7/1/10 © 2009 Turner et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Clinical practice guidelines (CPGs) are commonly used to support practitioners to improve practice. However many studies have raised concerns about guideline quality. The reasons why guidelines are not developed following the established development methods are not clear. The SEA-ORCHID project aims to increase the generation and use of locally relevant research and improve clinical practice in maternal and perinatal care in four countries in South East Asia. Baseline data highlighted that development of evidence-based CPGs according to recommended processes was very rare in the SEA-ORCHID hospitals. The project investigators suggested that there were aspects of the recommended development process that made it very difficult in the participating hospitals. We therefore aimed to explore the experience of guideline development and particularly the enablers of and barriers to developing evidence-based guidelines in the nine hospitals in South East Asia participating in the SEA-ORCHID project, so as to better understand how evidence-based guideline development could be facilitated in these settings. Methods: Semi-structured, face-to-face interviews were undertaken with senior and junior healthcare providers (nurses, midwives, doctors) from the maternal and neonatal services at each of the nine participating hospitals. Interviews were audio-recorded, transcribed and a thematic analysis undertaken. Results: Seventy-five individual, 25 pair and eleven group interviews were conducted. Participants clearly valued evidence-based guidelines. However they also identified several major barriers to guideline development including time, lack of awareness of process, difficulties searching for evidence and arranging guideline development group meetings, issues with achieving multidisciplinarity and consumer involvement. They also highlighted the central importance of keeping guidelines up-to-date.
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