The following is a reproduction from the Journal of the American Association of
Physicians of Indian Origin (JAAPI 1:(3), 2021) with permission.
©American Association of Physicians of Indian Origin (AAPI). All rights reserved.
Best Practices in Healthcare
International Standards, Guidelines, and Recommendations
Implementation Challenges and Critical Role of International Collaboration
Vemuri S. Murthy, M.D., M.S.
Advisor, Editorial Board, JAAPI
The Need for a Tailored Approach: “Think Global, Act Local”
“Best Practices in Healthcare” enhance global health. The core components of “Best Practices” include “Health Technology Assessment,” “Evidence-Based Medicine,” and “Clinical Practice Guidelines.” The efforts of International Health Organizations to improve patient outcomes through evidence-based recommendations for best practices are relentless. This editorial column takes an objective look at the realities (challenges) in implementing these standards in resource-limited countries and underserved communities to yield sustainable results.
Human ailments of different etiologies have been wreaking havoc for centuries, impacting longevity and the quality of human lives. The innovative human mind has been striving to reduce the impact of diseases through the medium of organized knowledge, which we call “Science.” The continuing human survival depends on the fruits of scientific research such as vaccines, antibiotics, chemotherapeutic agents, and other therapeutic measures.
As inventions emerged in every branch of science, the medical community focused more and more on basic and applied research with experimental trials. Of course, knowledge has always been there. However, the recommendations by the scientific community are solely driven by “evidence-based” knowledge that helps predict outcomes more accurately than ever before. As a result, they became benchmarks for quality healthcare and patient outcomes. “Translational Medicine,” the interdisciplinary branch of biomedicine with three pillars of “bench,” “bedside,” and “community,” has become the new buzzword in the scientific community promoting the application of laboratory research and preclinical studies to develop human trials.
The globalization of medicine is a boon to humanity. Sharing evidence-based scientific information among international peers with open communication channels leads to faster management of diseases with better patient outcomes. As a result, international affiliations and partnerships emanate rapidly during this century, unifying “silos of knowledge” from various parts of the world. The recent fast-track development of the COVID-19 vaccine exemplifies such global efforts.
Strategic planning of any successful global health project based on international guidelines needs “fine-tuning” in the real world as these recommendations face challenges for successful implementation in resource-limited countries and even in developed countries within their underserved communities. This is obvious when the same healthcare project design yields better patient outcomes in a well-served area compared to an underserved area. Even though basic healthcare access is considered a “human right” by global consensus, healthcare rationing is well-known in economically backward areas.
Preparing the ground is crucial before implementing any new undertaking. Healthcare projects are no exceptions. A comprehensive feasibility study is a prerequisite for initiating any project. In addition, local living standards, ease of access, and acceptance decide the survival of the projects in any community. Therefore, timely community