Page 149 - Shared Guideline Development Experiences in Fertility Care

this approach could be investigated in further detail by organizations that support, fund, or initiate the development of CPGs.
In the Netherlands, the rst step has already been taken towards more multidisciplinary thinking in the development of CPGs. Recently, the Dutch Ministry of Health established the Dutch Quality Institute, which aims to bring the quality of CPGs and their development processes to a higher level (www. zorginstituut.nl). is Dutch quality institute has made signi cant strides in de ning CPGs as part of ‘quality’; for example, in documents, they replaced the term ‘professional standard’ as de ned in the Dutch Health Insurance Act with ‘quality standards’. is term is now used to refer to a broader spectrum of quality documents (i.e. clinical practice guidelines, [care] standards, best practices, and quality indicators), which should concern the whole care process (www. glossarium.zorginstituutnederland.nl). Although the term ‘quality standard’ may refer to a multidisciplinary development process of the underlying documents, it still does not imply that patients play a substantial role therein.
In addition to the development and authorization of CPGs, the 32 Dutch associations of medical specialists have developed a jungle of (un)related
and unde ned quality documents: protocols, (care) standards, and national cooperation agreements. e ability of all these documents to actually contribute
to the quality of care seems questionable, especially when their content is unrelated
or even contradictory. To bring the quality of care to a higher level, patients,
health policymakers, guideline developers, and other allied stakeholders need
to collaborate on scoping, prioritizing, de ning, developing, and maintaining
clinical practice guidelines. Furthermore, it seems time to develop a uniform
vision for the de nition and the development process of related quality documents
to achieve this ultimate goal. We are convinced that our format could help these organizations further ensure collaboration and patient-centredness in clinical
guideline development, broadening quality standards, and actualizing content. 7
Patients and guidelines
When planning to transform the healthcare system from a disease-driven system into an integrated and patient-centredness-driven system, it seems logical that patients would play a key role in shaping and improving its quality. Corresponding with the ultimate goal of CPGs, patients should also play a key role in their development process. Although patient involvement in the main phases of Clinical Practice Guideline development has been urged internationally, implementing this
Discussion
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