Page 52 - Shared Guideline Development Experiences in Fertility Care

Chapter 3
We used advertisements and mailings over a period of seven months to invite patients with fertility problems to formulate recommendations via the Dutch online wiki-based tool at www.freyawiki.nl [18]. A patient representative and two members of the steering committee including the implementation expert modi ed and assessed the implementability of the patient recommendations with the GLIA Tool. en we asked patients to select their top three or ve recommendations for each wiki section (General care, General practice care, Gynaecologic care, Urologic care, and Laboratory) [18]. e guideline group assessed the eligibility of the nal set of patients’ recommendations within the scope of the guideline.
Integrating the guidelines
e MoGs addressed medical-technical aspects of care that needed improvement: physician care, care for patients su ering from unexplained infertility or male infertility, and fertility care given by clinical embryologists (semen analysis). e de nitive MuG described the overall clinical pathway of patients with fertility problems by merging the main medical-technical, patient-centred, and organizational recommendations from the MuG and MoG groups and the prioritized patient recommendations from WikiFreya [18]. e medical-technical recommendations included transitions in fertility care and care alignment. e patient-centred recommendations dealt with respect for patients’ values, preferences, and needs; information, communication, and education; emotional support; partner involvement; and the attitude of the fertility clinic sta . e organizational recommendations addressed coordination and integration of care, physical comfort, transition and continuity of care, access to care, and sta competence and technical skills. All patient recommendations obtained via WikiFreya were classed as Level P (Patient) evidence. To express patients’ input in the guideline, two patient representatives reformulated patient recommendations as: ‘Patients want to...’ e whole project was planned to be completed in 18 months.
Evaluation
We applied a stepwise process evaluation to the feasibility of this network approach [19]. e primary outcomes were ‘how’ the planned project was actually carried out and ‘how’ participants perceived the process; the secondary outcome was ‘what’ time was invested. We used a mixed-method evaluation including examination of secondary resources (such as project descriptions), interviews
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