The development and implementation of evidence-based palliative care guidelines for residential care : lessons for other countries

Guidelines are ‘systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances’ (1). In the last decade there has been worldwide interest in development and use of evidence-based guidelines. This has been driven by the imperative to limit variations in clinical practice for people with the same condition, uncertainty about the effectiveness of interventions in making a change in people’s health, and making the best of limited health resources within fiscal constraints. Whilst initially the focus was on how guidelines should be developed, this is now well defined and in Australia the National Health and Medical Research Council (NHMRC) (1) provides details of this process as does the National Institute for Health and Clinical Excellence (NICE) (2) in the UK. Several countries such as Australia, the UK, the USA, and Canada have national bodies that collate, synthesize, and publish evidence.