An Initiative on the development of Clinical Guidelines for Primary Health Care Centers in the West

1
An Initiative on the development of Clinical
Guidelines for Primary Health Care Centers in the
West NIS Partnerships.

• Dr. Ghenadie Curocichin
• Norfolk Partnership,VA-
• Chisinau, Republic of Moldova

2
The objectives of clinical guidelines

• Improvement of organizational performance
• Enhanced level of professional training for
  healthcare professionals
• Raised patients awareness of health issues
• Increased economic effectiveness in the centers
  work
• Introduction of evidence-based practice
• Regulation of practices legal aspects

3
Historical reference

• Primary Care Clinical Practice Guidelines
  Steering Committee Meeting (Moscow, April 2000)
• West NIS regional Steering committee meeting
  (Kyiv, August 2000)
• The group of authors works over the edition of
  the Reference Manual ( September 2000 - February
  2001)
• Presentation of the first version at the AIHA
  West NIS Regional Partnership Conference (Kyiv,
  February 2001)

4
Recommendations requirements

• Evidence-based approach
• Application to existing conditions
• Effectiveness
• Potential for further improvement
• Mechanisms available for implementation into the
  PHC practice
• Practicability

5
Applicability

• Economic acceptability
• Simplicity of implementation
• Acceptance by patients
• Proper technical equipment in PHC centers
• Sufficient level of personnel training

6
Effectiveness

• Economic
• Increase in number of positive outcomes of
  treatment
• Patients satisfaction
• Improvement in the populations health indices

7
Sections of the Reference Manual

• Organizational aspects of PHC
• Primary prevention
• Organization of patients immunization
• Most frequent clinical problems in family
  physician practice
• Contraception
• Ethical issues in family physician practice
• Interpretation of laboratory test results
• Model samples of outpatient charts

8
Most frequent clinical problems in the practice
of family physicians

• Therapeutic
• Pediatric
• Surgical
• Urgent states

9
Obstacles in the way of introduction

• Resistance to changes of health care
  professionals
• Lack of material and financial motivation for
  implementation
• Lack of information about the ways and tools for
  implementation
• Lack of legislative support
• Incongruity with patients expectations
• Relationships with sub specialists

10
Introduction process
Approval
Development
Testing in Partnerships PHC Centers (analysis of
the results)
Implementation in the PHC Centers