Study on the Development of an EU Framework for minimum quality standards and benchmarks in drug demand reduction (EQUS)The EU drugs action plan 2009–12 tasks the European Commission — with the support of the EMCDDA — to develop a European consensus on minimum quality standards and benchmarks in the field of drug demand reduction. The final report for the EQUS study has been presented to the European Council’s Horizontal Drugs Group on February 2012 and it is now available from the website of the leading research institution, Research Institute for Public Health and Addiction at www.isgf.ch.
Different lists of standards for Treatment and Rehabilitation, Prevention and Harm reduction are included in the report and they are presented in three different levels:
1- the intervention level (mainly of interest for professionals working in prevention, treatment and harm reduction services);
2 - the service level (mainly of interest for service directors);
3 - the system level (mainly of interest for policy planners and managers).
The final list of proposed minimum standards contains 33 standards for prevention, 22 standards for treatment/rehabilitation and 16 standards for harm reduction.
What are quality standards and guidelines for practices?
This section compiles quality standards and guidelines for the implementation of practices. The aim is to provide an overview on available standards and guidelines in EU Member States.
Quality standards and guidelines aim at improvement of quality and effectiveness of interventions.
Guidelines are “statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options” (Institute of Medicine, 2011). They are aimed designed to assist carers’ and clients’ decisions about appropriate interventions in specific circumstances.
Standards and quality standards are principles and sets of rules based on evidence used to implement the interventions recommended in guidelines. They can refer to content issues, processes, or to structural (formal) aspects of quality assurance, such as environment and staffing composition.
Protocols are documents that specify the procedures to follow to perform some tasks, typically those used to conduct a study.
Clinical pathways are structured, multidisciplinary plans of care designed to support the implementation of clinical guidelines and protocols.
Guidance is a general term that covers documents such as guidelines and quality standards.
Benchmarking is the process of comparing service processes and performance metrics to best practices from other services. Dimensions typically measured are quality, time and cost.
Accreditation is the process by which an institution delivering a service is independently assessed for quality against some pre-defined criteria. Accreditation requires a set of minimum standards, which are set by the accrediting body.
Adaptation of existing standards and guidelines
Quality standards and guidelines should be seen within the context in which they were developed. When applying existing standards and guidelines, these must always be checked for validity and, if necessary, adapted locally. To adapt guidelines (The ADAPTE Collaboration, 2011) to a specific context requires that a local group of stakeholders identify specific questions, searching for, retrieving and assessing available guidelines, and preparing the draft adapted guideline.
ADAPTE collaboration (2011), The ADAPTE process: resource toolkit for guideline adaptation (version 2.0 - http://www.g-i-n.net)
Institute of Medicine (2011), Clinical practice guidelines we can trust, The National Academies Press, Washington, DC.
Nils Brunsson and Bengt Jacobsson (2002), A world of standards, Oxford University Press.