The effects of a randomised multi-centre trial and international accreditation on availability and quality of clinical guidelines.
OBJECTIVE
To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation.


METHODS
Interventional "before-after" study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation.


RESULTS
The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non-accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p < 0.001) and in non-accredited units (both p < 0.02). The improvement of the systematic development scale was significantly higher in accredited than in non-accredited units (p < 0.01).


CONCLUSIONS
The combination of conducting both the DIPOM Trial and international accreditation led to a significant improvement of both dissemination and quality of guidelines on perioperative diabetic care.
Juul
Anne Benedicte
AB
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Gluud
Christian
C
Wetterslev
Jørn
J
Callesen
Torben
T
Jensen
Gorm
G
Kofoed-Enevoldsen
Allan
A
D000068:Accreditation / Q000592:standards*; D003718:Denmark; D003920:Diabetes Mellitus; D017408:Guidelines as Topic; D006801:Humans; D038622:Internationality; D019990:Perioperative Care; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011785:Quality Assurance, Health Care