Driehuis F1, Meerhoff GA1
1Royal Dutch Society for Physical Therapy (KNGF), Amersfoort, Netherlands
Background: Guidelines aim to improve the quality of patient care by combining scientific evidence, expert opinion and patient preferences. Monodisciplinary guidelines facilitate the delivery of care of a health profession in patients with a specific condition, whereas multidisciplinary guidelines aim to improve interprofessional collaboration and alignment in the delivery and organization of high quality care. Multidisciplinary guidelines are frequently initiated by external healthcare parties (EHPs), such as the association of medical specialists or general practitioners. Nowadays, the role and relevance of physical therapy in multidisciplinary healthcare delivery is growing. Active participation in the development of multidisciplinary guidelines has great importance for physical therapy, whereas it creates opportunities to sufficiently position physical therapy in the Dutch healthcare system.
Purpose: To improve the position of physical therapy in multidisciplinary guidelines in the Netherlands.
Methods: Since 2014, the Royal Dutch Society for Physical Therapy (KNGF) participated in over 70 multidisciplinary guidelines. The process of guideline development consists of a preparation-, developmental-, comment- and authorization phase, takes about 1.5 to 2 years and is funded to a limited extent by the EHP.
In the preparation phase an EHP invites the KNGF for participation in the guideline development. The KNGF selects, invites and informs a representative, with specific expertise with the condition of interest and preferably a scientific background, to represent physical therapy in the guideline panel. The panel determines and prioritizes guideline constructs of high interest, and is involved in the literature search, grading and interpretation of scientific evidence and the writing process (developmental phase). The KNGF representative has regular contact with the KNGF to discuss steps taken, decisions and the progress. Moreover, the representative is informed and methodically trained in the process of guideline development. During the comment phase the KNGF is invited to give feedback on the concept guideline. Once the guideline is definitive, the EHP asks the KNGF for acknowledgement of the guideline (authorization phase) and implementation among physical therapists.
Results: The multidisciplinary guideline 'Osteoarthritis hip-knee' was initiated by the Dutch Orthopedic Association (NOV). The KNGF was represented by a professor with specific expertise in osteoarthritis (TVV). TVV was also part of the expert group of the KNGF-guideline 'Osteoarthritis hip-knee' for physical therapists which was simultaneously developed by the KNGF with involvement of multiple EHPs, including NOV.
This interprofessional collaboration in the development of both guidelines resulted in recommendations concerning orthopedic surgery and advice in the KNGF-guideline and recommendations towards physical therapy in the NOV-guideline. As icing on the cake, it resulted in reinstatement of the reimbursement for physical therapy by the Dutch healthcare insurance system in patients with osteoarthritis.
Conclusion(s): Active participation in the development of multidisciplinary guidelines strengthens the position of physical therapy in healthcare and stimulates interprofessional collaboration to deliver high quality healthcare in clinical practice.
Implications: Intensive interprofessional collaboration on a policy and organizational level could lead to important healthcare system changes and increases the accessibility and patient centeredness of healthcare.
Future research should investigate whether multidisciplinary guidelines result in better patient care in clinical practice.
Keywords: Guidelines, Quality Improvement, Evidence Based Practice
Funding acknowledgements: The development and execution of the method was funded by the KNGF.
Purpose: To improve the position of physical therapy in multidisciplinary guidelines in the Netherlands.
Methods: Since 2014, the Royal Dutch Society for Physical Therapy (KNGF) participated in over 70 multidisciplinary guidelines. The process of guideline development consists of a preparation-, developmental-, comment- and authorization phase, takes about 1.5 to 2 years and is funded to a limited extent by the EHP.
In the preparation phase an EHP invites the KNGF for participation in the guideline development. The KNGF selects, invites and informs a representative, with specific expertise with the condition of interest and preferably a scientific background, to represent physical therapy in the guideline panel. The panel determines and prioritizes guideline constructs of high interest, and is involved in the literature search, grading and interpretation of scientific evidence and the writing process (developmental phase). The KNGF representative has regular contact with the KNGF to discuss steps taken, decisions and the progress. Moreover, the representative is informed and methodically trained in the process of guideline development. During the comment phase the KNGF is invited to give feedback on the concept guideline. Once the guideline is definitive, the EHP asks the KNGF for acknowledgement of the guideline (authorization phase) and implementation among physical therapists.
Results: The multidisciplinary guideline 'Osteoarthritis hip-knee' was initiated by the Dutch Orthopedic Association (NOV). The KNGF was represented by a professor with specific expertise in osteoarthritis (TVV). TVV was also part of the expert group of the KNGF-guideline 'Osteoarthritis hip-knee' for physical therapists which was simultaneously developed by the KNGF with involvement of multiple EHPs, including NOV.
This interprofessional collaboration in the development of both guidelines resulted in recommendations concerning orthopedic surgery and advice in the KNGF-guideline and recommendations towards physical therapy in the NOV-guideline. As icing on the cake, it resulted in reinstatement of the reimbursement for physical therapy by the Dutch healthcare insurance system in patients with osteoarthritis.
Conclusion(s): Active participation in the development of multidisciplinary guidelines strengthens the position of physical therapy in healthcare and stimulates interprofessional collaboration to deliver high quality healthcare in clinical practice.
Implications: Intensive interprofessional collaboration on a policy and organizational level could lead to important healthcare system changes and increases the accessibility and patient centeredness of healthcare.
Future research should investigate whether multidisciplinary guidelines result in better patient care in clinical practice.
Keywords: Guidelines, Quality Improvement, Evidence Based Practice
Funding acknowledgements: The development and execution of the method was funded by the KNGF.
Topic: Professional issues; Primary health care
Ethics approval required: No
Institution: KNGF
Ethics committee: KNGF
Reason not required: Ethics approval was not required because it is a description of a policy process without involvement of human subjects.
All authors, affiliations and abstracts have been published as submitted.
