Obtaining External Review and Updating the Guidelines

Three types of outside examiners can evaluate the guideline  

In addition, journals, sponsoring organizations, and other potential endorsers of the guidelines may undertake formal reviews. Each of these reviews can add value. 

As part of the guideline development process, a plan for updating should be developed. The importance of this step 

The term audit is associated with a particular connotation in healthcare, namely clinical audit and refers to the review of case histories of patients against the benchmark of current best practice. The clinical audit was proposed as a tool to improve clinical practice and a recent study indicates that it can do so, though the effects are modest. A more general role for audit, however, is that it can be used as part of the wider management exercise of benchmarking of performance with the use of relevant performance indicators against the performance of peers. 

Four distmct activities can be considered under the broad umbrella of an audit (1) solving problems associated with the process or outcome, (2) monitoring workload in the context of controlling demand, (3) monitoring the introduction of a new test and/or changes in practice, and (4) monitoring the adherence with best practices (e.g., with guidelines). 

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