VHA, in collaborations with the Department of Defense (DoD) and other leading professional organizations, has been developing clinical practice guidelines since the early 1990s. In 2010 the Institute of Medicine identified VA/DoD as leaders in clinical practice guideline development.
Implementation of evidence-based clinical practice guidelines is one strategy VHA has embraced to improve care by reducing variation in practice and systematizing “best practices”. Guidelines address patient cohorts, serve to reduce errors, and provide consistent quality of care and utilization of resources throughout and between the VA and DoD health care systems. Guidelines are also cornerstones for accountability and facilitate learning and the conduct of research. The guidelines on this site are those endorsed by the VA/DoD Evidence Based Practice Work Group.
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Guidelines
Clinical practice guidelines are used in health care to improve patient care as a potential solution to reduce inappropriate variations in care. Guidelines should be evidence based, incorporate patient input, as well as explicit criteria to ensure internal validity.
The use of guidelines must always be in the context of a health care provider's clinical judgment in the care of a particular patient. For this reason, the guidelines may be viewed as an educational tool to provide information in shared decision making.
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What's New!
July 2015 The Department of Veterans Affairs, Department of Defense and the Evidence Based Practice Program would like to announce that two Champions (John R. Downs, MD & COL Patrick G. O’Malley MD, MPH) who chaired the update of the clinical practice guideline, “The Management of Dyslipidemia for Cardiovascular Risk Reduction,” jointly wrote a synopsis for the Annals of Internal Medicine which is published in the August 2015 issue. The synopsis of the VA/DoD clinical practice guideline summarizes key features of the guideline in 5 areas: elimination of treatment targets, additional tests for risk prediction, primary and secondary prevention, and laboratory testing. Kudos to our VA Champion John R. Downs, MD and our DoD Champion COL Patrick G. O’Malley MD, MPH for a job WELL DONE! It is now available online at http://annals.org/article.aspx?articleid=2337281&resultClick=3.
View the full Dyslipidemia guideline and all the tools associated with the CPG on the internet.
Sept. 2014 Hip & Knee Osteoarthritis (OA)
The OA CPG recommends a framework that includes a structured evaluation and diagnosis of Veterans and Service Members who may be suffering from hip and knee OA. Additionally, the CPG provides treatment options, including pharmacological, non-pharmacological, complementary and alternative medicine, as well as options for referral for surgical consultation.
Sept. 2014 Upper Extremity Amputation Rehabilitation (UEAR)
The UEAR CPG is designed to address the key principles of rehabilitation and clinical care for patients with upper limb amputation. The overall goal of amputation rehabilitation is to optimize the patient’s health status, function, independence, and quality of life. Ongoing medical assessments and therapy interventions to address psychosocial, physical and functional limitations are necessary to achieve these desired end states.
VA/DoD Obesity Guideline Updated!
Includes objective, evidence-based information on the patient-centered approach to weight loss, the benefits and harms of pharmacologic and non-pharmacologic therapies, the management of comorbid conditions, best practices for care delivery, and emerging innovations in clinical research and care.
CPG Resources
| Evidence Based Practice Program Bibliography |
| Evidence-Based Synthesis Program |
| Guide to US Preventive Service Task Force |
| Pharmacy Benefits Management (VA) |
| VHA Preventive Health |
The following sites provide additional information on evidence-based clinical practice:
| QUERI - VA/HSR&D Quality Enhancement Research Initiative - which works to improve the quality of health care for veterans by implementing research findings into routine practice |
| National Guideline Clearinghouse* is a public resource for disseminating evidence-based clinical practice guidelines |
| MyHealthE Vet is the VA on-line personal health record that allows veterans to access their own health information as well as a wealth of patient education materials |
| U.S. Army Medical Command, Quality Management Office* is the world-wide contact point for clinical guidelines used by all branches of the service. |
* Links will take you outside the VA/DoD CPG web site. VA does not endorse and is not responsible for content on the linked sites.
CPG's in Publications