Published 12/31/2023
Barbara Krause

AAOS Offers Tools for Physicians to Integrate CPGs and Patient Education Resources into Clinical Practice

Clinical practice guidelines (CPGs) are systematically developed recommendations intended to assist healthcare professionals in making decisions about appropriate healthcare for specific clinical situations. The guidelines are based on the best available evidence from scientific research, expert consensus, and clinical experience. The primary goal of CPGs is to improve patient care by providing standardized, evidence-based recommendations that healthcare professionals can follow to provide the most effective and safe treatments and interventions for their patients. Furthermore, high-quality, patient-focused educational materials can answer questions and facilitate meaningful treatment discussions. Effective dissemination is crucial to ensure that CPGs have a meaningful impact on healthcare practices. AAOS has developed several tools to help effectively distribute and communicate these evidence-based guidelines.

AAOS’ OrthoGuidelines, a free online app available via Google Play or the App Store, currently houses 28 CPGs (both internally developed and endorsed external guidelines) that cover a wide range of medical topics, from preventive care and diagnostic approaches to treatment options for various orthopaedic conditions. OrthoGuidelines is also home to Appropriate Use Criteria (AUC) and CPG implementation resources. Although AAOS’ CPGs are easily accessible via the OrthoGuidelines app, the challenge continues to be implementing guideline recommendations into everyday clinical practice.

Disseminating a CPG is the process of distributing and communicating a guideline’s recommendations, information, and key findings to the intended audience. The ultimate goals of dissemination are to ensure that guideline recommendations reach their targeted audience and that the recommendations are effectively implemented into everyday clinical practice to improve overall patient care and reported outcomes. This process is vital, as it links research findings and their practical implementation, thus making evidence-based recommendations more accessible and actionable.

The following implementation tools are available via OrthoGuidelines or AAOS’ Toolkits, which are a collection of information to guide AAOS members and orthopaedic surgeons in making informed, evidence-based decisions for their patients.

Clinician checklists
AAOS developed the following checklists to improve clinician decision-making and clinical patient discussions. These checklists were developed via the AUC process using a modified Delphi method:

Impactful statements
An impactful statement is one that offers the potential for current evidence to change care offered to patients and is based on strong or moderate-strength recommendations from a CPG. This influence can be due to one or more of the following:

  • evidence highlighting current variations in care that were previously unsupported by evidence
  • current evidence supporting a significant difference or change from current clinical practice or previously held “gold standard” care

Some of the Impactful Statements developed from AAOS evidence-based CPGs include:

Plain language summaries
A CPG’s plain language summary describes the current state of the evidence for a specified disease or topic using patient-friendly, commonplace language to encourage conversations and shared decision making between patients and clinicians. The following plain language summaries have been developed based on CPG recommendations:

Patient handouts
Patient handouts allow clinicians to educate their patients and provide a higher level of understanding by furnishing them with valuable, evidence-based information on specific conditions or procedures in a manner that can be easily understood. Handouts also allow patients to be actively involved and well-informed in their own healthcare decisions and could potentially improve overall patient-reported outcomes. The following patient handouts are available from AAOS:

CPG slide decks
AAOS develops slide decks based on their CPGs to be used in presentations at grand rounds, conferences, or meetings. The slides are free for all to use, and users can modify presentation length by removing or combining slides to fit their needs. Slide decks have been developed for several AAOS CPGs, including:

Additionally, infographics on AAOS strong and moderate-strength CPG recommendations have been developed to assist clinicians in sharing clinical information on a specific condition and/or procedure using an easily understood visual format. Infographics can also assist with the overall clinician/patient decision-making process. Infographics have been developed for several CPGs, including:

The dissemination of CPGs is important, as these guidelines assist with improving patient-reported outcomes, standardizing and enhancing the quality of patient care, reducing variation in clinical practice, and supporting clinician and patient decision making.

Barbara Krause is the quality-improvement specialist for clinical quality and value at AAOS. She can be reached at krause@aaos.org.