Clinical standardization

Why is clinical standardization important?

Some people in our health system are receiving the best treatment. Unfortunately, some are not.

The Canadian Association of Emergency Physicians website says it best:

“Every Canadian has a right to a defined minimum standard of emergency care. A heart attack victim is entitled to receive the same benefit from recent advances in acute coronary care whether he be in Sydney, NS, or Saskatoon, SK.; a child with breathing difficulties from acute asthma, in Kelowna, BC or Kingston, ON, should be treated in accordance with a common current understanding of the disease process and effective available therapies. Where there exists good evidence for a clinical management approach for a given disease state, there should be no variability of quality of care on the basis of postal code.” (http://caep.ca/advocacy/romanow-commission/standardization)

The aim of the Clinical & Systems Transformation is to make the right thing the easy thing to do, every time.

Today, too much health care is inconsistent with what medical science tells us patients should receive. When we all consistently use the same protocols and checklists, quality and patient safety improve as variation and miscommunication decrease. We can then move forward with quality improvement and innovation, with a steady baseline against which to measure patient outcomes. Protocols are not set in stone; they are updated to reflect the latest evidence – but that evidence only holds water if it’s based on known standards.

Everyone can make mistakes, especially after a long shift or in stressful situations. Doing things the same way every time can help to minimize those mistakes. That’s why industries such as aviation and engineering spend so much effort on reducing unnecessary variations in processes. Clinical standardization doesn’t just help to prevent errors; it enables better proactive care, like earlier diagnosis and intervention – for example, sepsis prevention. When properly implemented and used, clinical standardization can also reduce unnecessary treatments, such as over-use of antibiotics.

For health professionals who are used to delivering care a certain way, standardization can seem intrusive and unnecessary at first; but standardized practices make it very clear what tasks need to be completed, and when – making it easier to meet consistently high standards of care.

Of course, medicine is a complex field, and it’s not getting simpler. Clinical judgement remains the key to excellent care. Each patient has individual needs, a unique history and their own personal preferences. With the best evidence-based guidelines available to use when they are needed, we can more confidently know that we are doing the right thing for each patient.