gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Development of multidisciplinary guidelines for perioperative processes: how to reach consensus efficiently?

Meeting Abstract

  • M. Pols - Association of Medical Specialists, Utrecht, The Netherlands
  • M. Ouwens - IQ Healthcare, Radboud University Nijmegen MC, Nijmegen, The Netherlands
  • T. van Barneveld - Association of Medical Specialists, Utrecht, The Netherlands
  • A. Wolff - Department of Anesthesiology, Radboud University Nijmegen MC, Nijmegen, The Netherlands

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP047

doi: 10.3205/12gin159, urn:nbn:de:0183-12gin1591

Published: July 10, 2012

© 2012 Pols et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: The Dutch Health Care Authority published three reports on the shortcomings in the organization of perioperative patient care.

Context: A multiprofessional working group developed three guidelines on perioperative processes with the aim to improve patient safety. Since there is little evidence, recommendations are mainly based on expert opinion and best practices. An efficient and transparant consensus method was required.

Description of best practice: In an overnight ‘pressure cooker’ meeting a core group analyzed the perioperative process and identified important safety items. Literature searches were carried out on the main topics. The core group formulated concept recommendations based on this analysis, literature, expert opinion and best practices. A broad expert group discussed the concept recommendations using an online modified Delphi procedure, Synmind, which is specifically developed for discussion and decision making. Experts scored the importance of these recommendations for patient safety. They motivated their score and gave suggestions for improvement. They discussed the results of the Synmind session in a plenary meeting to reach final agreement. Feasability of the recommendations was tested in five hospitals.

Lessons for guideline developers, adaptors, implementers, and/or users:

  • Working with a core group facilitates keeping the momentum in guideline development.
  • A single multi-day meeting can be more productive than multiple short meetings.
  • An online Delphi procedure in combination with a single plenary meeting is an efficient procedure to structure and formalize the consensus process.
  • This process can be completed within months.