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Protocols for the obvious: Where does it start, and stop?

Armand R J Girbes¹, Paul E Marik²

¹Department of Intensive Care, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. a.girbes@planet.nl.

Annals of Intensive Care

|April 16, 2017

Summary

Evidence-based protocols can aid clinical trials, but bundling unproven elements with standard practices is discouraged. Implementing entire protocol bundles without critical evaluation may hinder optimal patient care.

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Area of Science:

Clinical practice guidelines
Medical research methodology

Background:

Protocols and checklists offer benefits in specific clinical situations and trials.
Evidence-based protocols often include obvious reminders for clinicians.

Discussion:

Bundled protocols may contain elements lacking strong current evidence.
Quality improvement programs sometimes mandate total bundle implementation.
This practice of implementing unvetted bundles is questioned.

Key Insights:

While protocols can be beneficial, their components require scrutiny.
Not all elements within a bundled protocol may be evidence-based.
Blindly adopting entire protocol bundles can be problematic.

Outlook:

Keywords:

Intensive care Protocols Quality improvement Safety

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Future research should focus on selective protocol component evaluation.
Clinicians should critically assess bundled protocols before full implementation.
Promoting evidence-based selection of protocol elements is crucial.