What Is EM Practice Guidelines Update All About?
In recent years, there has been a proliferation of practice guidelines (also referred to as clinical policies or practice parameters). Thousands are in existence, and, though many are directly related to emergency practice, dissemination of these recommendations often fails to reach the primary users. To facilitate guideline utilization, a National Guideline Clearinghouse has been established, which can be accessed on the internet at http://www.guideline.gov; however, uploading the guidelines is often delayed. There continues to be an unmet need of practicing emergency physicians being up to date on practice guidelines relevant to emergency practice.

Practice guidelines are documents that are developed to assist clinical decision making. They are intended to assimilate the large volume of knowledge available from both the literature and from expert opinion into strategies helpful in diagnostic, management, and resource utilization decision making. Ultimately, clinical policies have been used as tools in quality assurance programs, in creating health care policy, in directing research agendas, and in medicolegal determinations.

Once a clinical policy is developed, its recommendations can be constructed into an implementation tool such as a “clinical pathway” or an “annotated algorithm,” which take into account the resources available; this is a tool which is incorporated into each issue of Emergency Medicine Practice.

Critically assessing practice guidelines: Because of variations in guideline development methodology, it is necessary to critically assess a guideline before it is adopted. In order to do this, several questions must be asked:

1. Why was the topic chosen and are the objectives and goals clearly stated?
2. What are the credentials of the policy’s authors and do they have the expertise to competently assess the subject?
3. What methodology was used to generate the policies recommendations?
4. Does the format enable readability, accessibility, and retrievability of information in the policy?
5. Was the clinical policy field tested or reviewed in clinical practice?
6. When was the policy written, and is there a mechanism to keep it current?

The publication, EM Practice Guidelines Update, will answer these questions and more in each monthly edition. 

EM Practice Guidelines Update was created to meet the need of emergency physicians to stay current with practice guidelines that were designed to assist clinical decision making in the emergency department. Guidelines presented will be drawn from a variety of specialty sources. They will be analytically reviewed using a systematic approach; when indicated, editorial commentary will be provided. It is hoped that EM Practice Guidelines Update will become a valued resource facilitating best practice in emergency care.