The Academy of Preventive Medicine is committed to improve the quality of health services through the introduction of evidence-based clinical standards. This includes improving the quality of care, resulting in improved clinical outcomes; improving quality of services (patient satisfaction is one dimension); improving quality of resource use (from stewardship of the system to cost-effectiveness of individual interventions); and improving quality of the health workplace (including compensation and supportive supervision). This requires a multi-step approach and includes.
• The development of a small number of clinical standards in a high disease priority region for a target area, such as reproductive health or a type of cancer.
• Applying the clinical standards developed in the pilot to inform policy decisions in a particular setting, such as a regional hospital.
• Building the technical capacity for clinical epidemiologists, statisticians, health economists, experts in critical appraisal and health technology assessment.
• Evaluation the impact of standards on quality and efficiency, patient and professional satisfaction.
• Formalizing standard development methods and processes. The standards could be used, adapted to the local setting, by other regions of Kazakhstan.
Evidence-based medicine (EBM) and evidence based practices are key components of improving the quality of clinical outcomes. EBM is not simply the development of guidelines and standards using reviews of literature and analyses of scientific studies, although this approach can help guide national policy and provide tools for health providers. EBM is also the practice of making decisions about health care at the service delivery level, based on the best available, current, valid and relevant evidence, clinical experience, and ultimately, the patient’s values and wishes.
In general, Kazakhstan’s standards tend to be broader and more inclusive especially of new health technologies, including access to diagnostics and interventional procedures.
Kazakhstan Academy of Preventive Medicine applies international standards adopted from such databases as:
• National Institute for Health and Clinical Excellence – UK: www.nice.org.uk
• Scottish Intercollegiate Guideline Network – UK: www.sign.ac.uk
• National Guideline Clearing House – US: www.guideline.gov
• United States Preventive Services Taskforce – US: www.ahrq.gov/clinic/USpstfix.htm
• DERP- US: http://www.ohsu.edu/drugeffectiveness
• National Quality Forum – US: http:www.NQF.org
Introduction of international evidence-based standards is a multi-step process. It requires active participation of stakeholders, doctors, pharmacists, etc.