Overview
The CPGs
The paediatric clinical
practice guidelines (CPGs) are point of care guidelines, developed to assist
clinicians with decisions about appropriate health care for children and young
people. This process was initiated by the
Department of General Medicine and the Centre for Community Child Health and
Ambulatory Paediatrics and has been in progress since February 1996.
The CPGs are designed
to acquaint the reader rapidly with the clinical problem and provide practical
advice regarding assessment and management. They do not constitute a textbook
and therefore deliberately provide little, if any, explanation or background to
the conditions and treatment outlined. Where possible, these CPGs are
developed by a multidisciplinary team of practising clinicians by consensus and
based on the evidence available.
CPG development and maintenance is overseen by the CPG development
group, contactable at cpg@rch.org.au.
The CPG Committee
The committee is a
passionate group of clinicians from General Paediatric, Emergency medicine and
General practice, including medical staff (consultants and trainees), nursing
staff and allied health staff largely from RCH & Monash, however also other
health services across Victoria and in 2019, New South Wales and Queensland.
Committee meetings are held
at RCH (and via video link) from 3-4pm on the 1st Thursday and 3rd
Wednesday of every month.
The committee members
volunteer their time to review CPG drafts and provide feedback by email and/or
by attending the twice monthly CPG committee meetings. CPG drafts are
circulated to the committee via email prior to the meeting. Feedback should be
sent back to the CPG fellow, discussion list or CPG author, where appropriate,
prior to the CPG committee meeting for that particular CPG. Feedback includes the
option of an approval email from committee members, submitted to demonstrate
that the CPG has been reviewed and no changes are suggested.
The discussions, online and at the meetings, are often vigorous, as the
committee members are passionate, dedicated clinicians with a keen interest in
the CPGs. We aim to promote enthusiastic but respectful discussions in order to
develop robust evidence and consensus based guidelines in a supportive
environment.
The Paediatric Improvement Collaborative (PIC)
The PIC formed in
early 2018, it is a collaborative between RCH, Safer Care Victoria (SCV,
Victorian Department of Health), the NSW Agency for Clinical Innovation and
Clinical Excellence Queensland.
One of the main aims of the PIC is to
reduce unwarranted variation in clinical care via the development, endorsement,
publication and promotion evidence based paediatric clinical practice
guidelines (CPGs) that outline best practice clinical management of high volume
and high risk paediatric clinical conditions. The PIC oversees the
transition of the Victorian Statewide CPGs to new PIC CPGs that can be used in
QLD, NSW & VIC, with the hope the other states will join in the future.
Each
of the states involved have appointed representatives to assist with the
application of local and state based knowledge to the CPGs during the
development and review process (below) ensuring relevance to all CPG users.
State representatives will be involved in the extended review process as part
of the CPG committee and the simple/intermediate review process through direct
liaison with the CPG Development Group.
The PIC has approved the attached "Paediatric Clinical Practice Guidelines: Development and Endorsement Process"
Process
The Development and Review process:

Authors (extended review)
Committee members and other associated interested clinicians can
undertake an extended review of a current CPG or develop a new CPG after
discussion with the CPG development group. Topics are chosen based on the
authors areas of interest and priorities determined by the PIC and RCH.
A template is provided for writing the draft CPG. The CPGs are
developed or reviewed by a primary author often supported by a consultant on
the CPG committee.
The support provided includes:
- Initial
advice regarding the aim/s and direction of the CPG
- Follow up support by
reviewing the draft during the process and before submitting it to the
committee for feedback.
The CPG is emailed to the committee for review 2 weeks prior to the
committee meeting. At the committee meeting, the draft CPG is discussed from
start to finish, to ensure the aim/s of the CPG are met and each point of
information or advice conveys the appropriate message. This may include edits
or suggested changes to language, clinical information, structure
or formatting.
A final draft is completed by the original author for either
resubmission to the committee, or submission for final checks by the CPG
development group prior to publication on the website.
Timeline for extended review of a CPG
- Allocation of a CPG topic
to the primary author at least 6 weeks prior to the scheduled date for
presentation at a CPG committee meeting.
- Draft submitted to CPG fellow
and then distributed to CPG committee via email 2 weeks prior to the scheduled
date for presentation at a CPG committee meeting.
- Committee members can
provide feedback regarding the draft via email to the distribution list or
contact CPG fellow directly prior to scheduled date for presentation at a
CPG committee meeting.
The Simple/Intermediate Review Process
This process
was implemented to ensure that all CPGs, particularly those less likely to
change significantly over time, are up to date with content and formatting. This
review includes a literature review is undertaken by a CPG fellow, with supervision
by a CPG consultant. Subspecialists or relevant stakeholders may be contacted
during the process for specific questions. If significant changes are required
the CPG committee will be consulted.
Once this is
finalised within the CPG development group, the CPG is sent to the interstate
representatives for review of applicability to their state, including relevance
of recommended medications and local equivalent of the suggested services
and/or resources.
Interstate
representatives can involve other local reviewers in reviewing the CPG. Wider
feedback received is collated by the interstate representatives before
forwarding back to the CPG development group, for finalisation. From there, the
endorsement process is equivalent to the extended review process.
Other Resources
Link to an NHMRC guide on writing information sheets for
families.
RCH CPG developer's site