Funding for ACEP clinical policy development is provided mainly by the College, although in rare cases there has been topic-specific funding by the Centers for Disease Control and Prevention and the Emergency Medical Services for Children National Resource Center. Companies are not allowed to participate in or provide direct support for the development of ACEP’s clinical policies.
Recent Improvements to the Development Process
The most substantial recent improvement to the development process is the inclusion of additional methodologists with formal advanced training and applied methodological and emergency medicine experience. Historically, all evidence grading was performed by CPC subcommittee members. This difficult and demanding task is now performed by a team of methodologists. We feel this will improve and standardize the grading process.
We have also received approval and have increased the committee membership in 2014 and have been provided additional staff assistance. We welcome Mary Anne Mitchell, ELS, who will now be assisting Rhonda Whitson, RHIA, our long-time staff member, in our CPC activities.
Other recent changes include increasing the clinical policy draft open comment time period from 30 to 60 days, allowing member input on clinical policies areas for focus within clinical policy topics, and soliciting Board comments on the topic-specific critical questions.
The industry of clinical guideline and clinical policy development has made significant strides over the past several years. As a committee, we have attempted to incorporate these changes into our processes and products. Conflict of interest (COI) is one such area. Over the years, the CPC has strengthened the processes related to the identification of both financial and intellectual COI, asking for more details from committee and subcommittee members. In 2011, even more focus was put on COI submissions when the Council of Medical Specialty Societies published its “Code for Interactions With Companies” and the Institute of Medicine released their report, “Clinical Practice Guidelines We Can Trust.”1,2
The national expectations for clinical policies have increased over the years. Currently, we are implementing the recommendation from the Agency for Healthcare Research and Quality that we explicitly list potential benefits and harms for each policy recommendation.
For more than 25 years, the CPC has worked to provide valuable assistance to emergency physicians for the care of their patients. This remains a challenging and rewarding area of effort. We appreciate the support of ACEP members, the ACEP Board, Council Officers, and staff in our ongoing work. Special thanks to the full ACEP Board and especially to Dr. Robert O’Connor and Dr. Alex Rosenau for their support while we continue to improve the CPC processes. Much of this work was begun under the leadership of the late Dr. Francis Fesmire.