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BCGP
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BEDSIDE CLINICAL GUIDELINES PARTNERSHIP

Clinical guidelines are very difficult to produce and particularly demanding to
maintain. They need to be researched, written, debated, checked, edited,
formatted, proofed and disseminated.

The Bedside Clinical Guidelines Partnership provides a solution; guidelines with
easily accessible point of care information to help reduce the risks associated
with inconsistency of




WHAT IS THE BEDSIDE CLINICAL PARTNERSHIP TRUST?

With over 16 years experience and a current membership of over 20 acute NHS
Trusts across the country, the Bedside Clinical Guidelines Partnership (BCGP)
have a solid foundation in the production of point of care guidelines for
clinician use at the bed-side.

Formed initially to produce guidelines for Adult Medicine care, as interest and
resources have grown, the scope has extended. The BCGP now produce guidelines
for all the following specialities:



 * Adult Medicine
 * Adult general surgery
 * Adult nursing
 * Emergency medicine
 * Neonatal
 * Obstetrics
 * Paediatrics



Guidelines are written and reviewed by specialists with support from qualified,
trained and experi-enced pharmacy, biochemistry, microbiology, radiology,
library and publication staff. They are checked against national guidance,
specialist societies and evidence reviews when available. Editors within the
BCGP then peer review the material and offer challenges, comments and their own
contributions. This combined expertise and experience help make the guidelines
independent.

Wherever possible, recommendations made are evidence based. Where no clear
evidence has been identified from published literature, the advice given
represents a consensus of the expert authors and their peers and is based on
their practical experience.

For ease of reference, the layout adopts a standard format, covering Recognition
and assessment, Immediate treatment, Subsequent management, Monitoring treatment
and Discharge and follow-up.

The use of bulleted short statements in the active tense, accompanied by
bold/italic typeface to alert or caution is used.


WHO DOES WHAT?

The Partnership is managed by an editorial board, comprising a clinical lead
consultant physician, and eight specialty editors (seven consultant grade and
one senior nurse who each allocate time to review and edit the guidelines). The
guidelines team also includes two fulltime developer/co-ordinators and a
clinical effectiveness librarian, working to an annual reviewing and updating
cycle.


HOW OFTEN ARE THEY UPDATED?



 * Medical, Surgical and Nursing: Every year
 * Paediatric, Neonatal, Obstetric & Emergency medicine: Every two years




WHY DO WE NEED GUIDELINES

To achieve the highest standards of evidence-based practice, reduce unnecessary
and costly variation in practice and to reduce risk. This is increasingly
important as clinicians work shorter hours with patients being cared for by
changing personnel.


ARE THE GUIDELINES NOT A DUPLICATION OF THOSE FROM NICE?

No. Our guidelines are a fusion of national guidance and everyday clinical
practice and experience; together in one volume per specialty. They are brief
and to the point - a guide to what to do now.


ARE THE GUIDELINES MADATORY?

The guidelines are not intended as a substitute for logical thought and must be
tempered by clinical judgement in the individual patient. No guideline will
apply to every patient, even where the diagnosis is clear-cut; there will always
be exceptions.

The guidelines are designed to assist clinicians and help to promote
consistency, but recognise that patients are individuals, possibly with
co-morbidities or allergies that require alternative management. Clinicians must
be free to adapt the guidelines, which are explicitly advisory, not mandatory.
Divergence does not necessarily signify negligence.


WHAT DOES MY TRUST RECEIVE FOR ITS INVESTMENT?

All the present guidelines on CD-ROM in a format that can be modified by you to
suit your local circumstances, followed by annual or biennial updates of each
set of guidelines. A PDF version is also pro-vided to enable each Trust to put
the guidelines on their intranet.


MY TRUST IS ONLY INTERESTED IN ONE SET OF THE GUIDE-LINES - CAN WE PURCHASE JUST
THE ONE WE WANT?

We do not sell the guidelines separately; as a member you get ALL the guidelines
for use within your Trust and your subscription fee helps to support the
guideline process. However, it is up to individual Trusts which guidelines they
use and how they tailor them to their needs.


HOW DO WE TAILOR THE GUIDELINES TO OUR TRUST?

The CD-ROMs include a style guide and information regarding the guidelines we
suggest are reviewed for your local content. All the files use colour-coded text
to help members identify where local information may be required.

However, the paediatric, neonatal and obstetric guidelines are actually quite
generic as they are authored by two networks consisting of members from a number
of different Trusts. We find that, unlike medicine and surgery, there aren't
usually too many changes required. The main area for review is the recommended
antimicrobials and most Trusts have local policies on these.

We do suggest that guidelines are reviewed by consultants/clinical nurse
specialists leading for, or inter-ested in, the subspecialty guideline and
amended accordingly. There may also be some differences in regional policies and
pathways that may not be consistent with your Trust.

Some partner Trusts amend to their local policy and then put on to their
intranet, once this has been done they find that updating is much simpler next
time as they just use the changes in blue that we send year on year. However, we
also know that many of our partner Trusts simply take the guide-lines as they
are, accessed via their intranet with caveats regarding antimicrobial policy,
advising users where local information is found.


HOW MUCH DOES MEMBERSHIP OF THE BEDSIDE CLINICAL GUIDELINES PARTNERSHIP COST?

Our annual subscription fee is currently £5,250 per annum on a recurring basis.


DOES THE PARTNERSHIP MAKE A PROFIT?

No. The partnership is constructed as a non-profit making group. The running
costs of the secretariat (editors, pharmacists, clinical effectiveness librarian
and developer/ co-ordinators) are borne equally by all partner Trusts.


CONCLUSION

It is our belief, on the basis of experience, that goodquality guidelines have
huge potential to improve care, especially in these days of shifts, with
multiple doctors involved in the care of individual patients.

However, the development of guidelines requires dedicated resources and a well
defined process. It is best undertaken across a network of co-operating
providers. Audit, regular review and updating are essential components of the
process.

Investment in the partnership gives you bedside guidelines that bring together
in one easily-accessible format, current guidance, information and best practice
from all corners of the world of health-care.

Clinical guidelines are 'systematically developed statements to assist
practitioner and patient decisions about appropriate healthcare for specific
clinical circumstances1' They present recommendations for optimal management,
informed by pub-lished evidence and broad consensus, and encourage flexible
application in individual patients.

1 Field MJ, Lohr KN, eds. Clinical practice Guidelines: directions for a new
program. Washington, DC: National Academy Press, 1990


INTERESTED IN JOINING? WANT TO KNOW MORE?

To request further information or samples of the guidelines and their supporting
information contact us either via

(01782) 676697/676698

bedsideclinicalguidelines@uhnm.nhs.uk


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