Best Practice Guidelines

“Best practice guidelines (BPGs) are systematically developed evidence-based documents that summarizes research and provide recommendations to health care providers, leaders and policy makers, patients and families regarding a clinical or health care topic [11]. BPGs can be used to bridge the gap between research evidence and clinical practice by synthesizing evidence for health professionals [4,12]. BPGs have become a common feature of health service organizations internationally and are of interest worldwide as a tool to facilitate more consistent, effective, and efficient practice [12]. Recent synthesis studies focused on the implementation of clinical practice guidelines reported that these tools can have a positive impact on providers’ knowledge, behaviour and patient outcomes in the context of interdisciplinary and team based care [13], arthritis, diabetes, colorectal cancer and heart failure care [14], cancer care [15], nursing care [16], broadly across 16 clinical topics [17], and health systems in low- and middle-income countries [18]. These synthesis studies summarized the implementation barriers and facilitators [18], the dissemination and implementation approaches and strategies used during guideline implementation [[13], [14], [15], [16], [17], [18]] and outcomes (changed in attitude, knowledge, behaviour by health care providers or improvement in patient outcomes) resulting from application of implementation strategies [15,16,18]. Peters and colleagues [17] identified 11 theories and frameworks that were used in 25 studies in planning their implementation approach.”

Pharmaceutical Costs

“Reimbursement contracts, in which health insurers receive rebates from drug manufacturers instead of paying the transparent list price, are becoming increasingly common worldwide. Through interviews with policy makers in nine high-income countries, we describe the use of these contracts around the globe and identify related policy challenges and best practices. Of the nine countries surveyed, the majority routinely use confidential reimbursement contracts. This alternative to drug coverage at list prices offers benefits but is not without challenges. Payers face increased administrative costs, difficulties enforcing contracts, and reduced information about prices paid by others. Among the best practices identified, policy makers recommend establishing clear and consistent processes for negotiating contracts with relatively simple rebate structures and transparency to the public about the existence, purpose, and type of reimbursement contracts in place. Policy makers should also work to address undesirable price disparities within their countries and internationally, which may occur as a result of this new pricing paradigm.”

Pharmaceutical Costs

“Our telephone interviews and in-person discussions with policy makers revealed one overarching lesson for payers that engage in reimbursement contract negotiations: Payers, particularly those new to reimbursement contracts, must take ownership of this emerging pricing paradigm by creating policy structures that give them control in negotiations and legitimacy in their decision making. To be effective, we argue, such policy structures must follow three critical principles: pragmatism, discipline, and transparency.”

Long-Term Care and Dementia

“A Cochrane review of special care concluded that implementing best practices may be more important than providing a specialized care environment. ²⁴ These findings may be reassuring to the families of the 70 percent of assisted living residents with moderate or severe dementia who do not reside in special care units. Best practices include pleasant sensory stimulation ^25,26 and the use of protocols for individualized care ^27,28 and to improve function. ²⁹

“Specialized dementia settings admit more residents with moderate or severe cognitive impairment or behavioral symptoms and are less likely to discharge residents for those behaviors, which indicates that they may play a role in promoting aging in place. This is an important consideration, given the risks that accompany people’s transitions across care settings. However, aging in place should not be promoted if necessary services are not available.”

Source: Sheryl Zimmerman, Philip D. Sloane, and David Reed. Dementia Prevalence And Care In Assisted Living. Health Affairs 2014 33:4, 658-666.

Transitioning Internationally Qualified Nurses Into The Workforce

“According to this review, internationally qualified nurses who immigrate to developed countries face obstacles in effectively utilising their specialised skills. The registration, accreditation, immigration, and employment processes for healthcare professionals in developed countries are influenced by regulatory, legislative, and assessment agencies, which creates difficulties for these nurses in finding a clear pathway to apply their specialty skills (Cooper et al., 2020). A gap in knowledge of the nurses and recruiting managers about the internationally qualified nurse journey, the previous course they completed, and the level of skills they possess were also evident in the literature, which hinders the successful utilisation of the specialty skills (Kishi et al., 2014; Kurup et al., 2022; Smith et al., 2011; Zhou, 2014; Zhou et al., 2011). Establishing specific certification requirements for immigrant nurses’ specialty abilities allows them to fully participate in the host country’s health system while contributing to safer care delivery (Xiao et al., 2014). By utilising internationally qualified nurses’ specialty skills, host countries such as Australia can maintain professional practice standards and ensure the safety of their healthcare clients while also meeting ever-changing labour demand trends (Hawthorne, 2013).”

Source: Kurup C, Betihavas V, Burston A, Jacob E. Strategies employed by developed countries to facilitate the transition of internationally qualified nurses specialty skills into clinical practice: An integrative review [published online ahead of print, 2023 Oct 4]. Nurs Open. 2023;10.1002/nop2.2023. doi:10.1002/nop2.2023

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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated October 17, 2023 by Doug McVay, Editor.