Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way

Abstract

'Ashley Farley' 'Andrés M Rubiano' 'Maria Michaels' 'Meghan B Lane-Fall' 'Michael A Person' 'Vanessa P Ho' 'Linda Reinhart' 'Elliott R Haut'] Title: Summary Thirty-four per cent of deaths among Americans aged 1-46 are due to injury, and many of these deaths could be prevented if all hospitals performed as well as the highest-performing hospitals. The Institute of Medicine and the National Academies of Science, Engineering and Medicine have called for learning health systems, with emphasis on clinical practice guidelines (CPGs) as a means of limiting preventable deaths. Reduction in mortality has been demonstrated when evidence-based trauma CPGs are adhered to; however, guidelines are variably updated, redundant, absent, inaccessible, or perceived as irrelevant. Ultimately, these barriers result in poor guideline implementation and preventable patient deaths. This multidisciplinary group of injury providers, clinical guidance developers and end users, public health and health policy experts and implementation scientists propose key areas for consideration in the definition of an ideal future state for clinical guidance development and dissemination.