Implementation of Clinical Protocols in Practical Healthcare: The Views of Doctors

Abstract

Clinical protocols, developed on the basis of evidence-based medicine, adapted on the basis of international clinical guidelines, determine the optimal options for the diagnosis and treatment of patients. However, the implementation and application of clinical protocols in daily practice often encounters barriers of various kinds, including skepticism on the part of practitioners themselves.
The purpose of research: Assess the level of accessibility and effectiveness of application of clinical protocols. Identify barriers to the effective implementation of clinical protocols in practical healthcare.
Methods. To assess the effectiveness of the implementation and use of clinical protocols in practical healthcare, in September 2023, we conducted a social survey of doctors working in medical organizations providing inpatient, inpatient replacement and outpatient care at the regional, city and district levels. A total of 2.717 doctors took part in the survey. The study is based on the Order of the Ministry of Healthcare of the Republic of Kazakhstan dated November 12, 2020, No. 189/2020 of the Ministry of Healthcare of the Republic of Kazakhstan on the assessment of the implementation of clinical protocols in medical
organizations. The questionnaire included several questions on monitoring the implementation of clinical protocols. The questionnaire also included 16 questions to study the opinion of doctors on the effectiveness of using clinical protocols in daily practice and obstacles to the use of clinical protocols.
Results. The survey showed that doctors face a number of barriers that prevent the implementation of the recommendations of clinical protocols in full in practice. The following barriers were noted: insufficient equipment of medical organizations (lack of necessary equipment – 27.63%), problems with procurement and drug provision (lack of necessary medicine – 9.84%), shortage of personnel and other reasons.
Conclusions. A significant part of the barriers identified in assessing the level of accessibility and effectiveness of the use of clinical protocols require management decisions from the heads of medical organizations and regional health departments. Specialists responsible for the implementation of clinical protocols should assess available resources, identify obstacles to the implementation of clinical protocols in practice and promptly inform the heads of medical organizations to jointly develop solutions to eliminate obstacles.