Jessie McGowan1, Sergei Muratov2, Anna Tsepke3, Arman Issina4, Eva Slawecki5, Eddy S Lang6. 1. Department of Medicine, University of Ottawa, 85 Primrose Ave, Ottawa, ON, Canada K1N 6M1. Electronic address: jmcgowan@uottawa.ca. 2. Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1. 3. Republican Helthcare Development Centre, 4 Orynbor St., Astana, Kazakhstan, 010000. 4. Canadian Society for International Health Project Manager, Astana, Kazakhstan. 5. Canadian Society for International Health, One Nicholas, Suite 726, Ottawa, ON K1N 7B7. 6. Clinical Department Head for Emergency Medicine, Alberta Health Services, Calgary Zone, Academic Department Head for Emergency Medicine, Associate Professor of Emergency Medicine, Cumming School of Medicine, University of Calgary, RGH, Holy Cross Ambulatory Care, 7007 - 14 St. SW - Room 5A105, Calgary, AB Canada T2V 1P9.
Abstract
OBJECTIVES: In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING: A pragmatic CPG adaptation process was developed that took into consideration national and local contexts. A 15-step process ranging from topic prioritization to copyright clearance to final Ministry of Health approval was developed. An implementation strategy was developed and piloted in three local regions using a five-step approach. RESULTS: High-quality international CPG candidates were identified for all topics; forty-two CPGs were adapted locally by the clinical working groups. Three CPGs using 21 recommendations were implemented locally. Many challenges were identified including priority setting, obtaining permission to use and translate guidelines into Russian and producing high-quality translations, and organizational barriers during implementation. Facilitators included tools to guide the process and the creation of working groups. CONCLUSION: We describe a process of large-scale adaptation of international CPGs with the pilot implementation of selected adapted CPGs and recommendations. Further evaluation and monitoring are required to ensure its integrity.
OBJECTIVES: In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING: A pragmatic CPG adaptation process was developed that took into consideration national and local contexts. A 15-step process ranging from topic prioritization to copyright clearance to final Ministry of Health approval was developed. An implementation strategy was developed and piloted in three local regions using a five-step approach. RESULTS: High-quality international CPG candidates were identified for all topics; forty-two CPGs were adapted locally by the clinical working groups. Three CPGs using 21 recommendations were implemented locally. Many challenges were identified including priority setting, obtaining permission to use and translate guidelines into Russian and producing high-quality translations, and organizational barriers during implementation. Facilitators included tools to guide the process and the creation of working groups. CONCLUSION: We describe a process of large-scale adaptation of international CPGs with the pilot implementation of selected adapted CPGs and recommendations. Further evaluation and monitoring are required to ensure its integrity.