Toward national health system guidelines in Canada: reflections of a comprehensive audit

A comprehensive assessment of the Health Program Guidelines (HPG) in Canada was undertaken between January and September 1992. This review examined the strategic effectiveness and operational efficiency of the guidelines under the auspices of the Federal, Provincial and Territorial Committee on Institutional and Medical Services. To assess the perceived needs for the guidelines, over 185 structured mail questionnaires were sent to a sample of health care agencies, institutions and organizations across Canada; the response rate was over 80.5%. A key informant approach was also used to assess the perceived effectiveness and efficiency of the guidelines. Based on the results of the questionnaires, over 45 interviews and an extensive content analysis of key documents, recommendations were made that may be relevant to the Canadian health system community.