The Institute of Medicine Washington defined clinical guidelines as a ‘systematically developed set of statements to assist the practitioner and patient’s decisions about appropriate health care for specific clinical circumstances’ (Field and Lohr 1990, p.4). They may offer concise instructions on which diagnostic or screening tests to order, how to provide medical or surgical services, how long patients should stay in hospital, or other details of clinical practice. According to the NSW Ambulance Service ‘protocols have been designed to streamline patient care’ (Adelstein and O’Connell 2001, p.1).
According to Choudhdry, Stelfox and Detsky the ‘ascendency of evidence-based medicine over the last decade has fostered an unprecedented growth in clinical practice guidelines’ (2002, p.612). Departments of health and associated agencies, specialty societies and other medical organisations have all embraced the development of guidelines in the belief that adherence to their recommendations translates into benefits for patients (improved outcomes), practitioners (improved quality of care), and providers (improved cost-effectiveness)(Chassin et al 1986, p. 314).