The effects of a randomised multi-centre trial and international accreditation on availability and quality of clinical guidelines

Int J Health Care Qual Assur Inc Leadersh Health Serv. 2005;18(4-5):321-8. doi: 10.1108/09526860510602587.


Purpose: To examine the availability and quality of clinical guidelines on perioperative diabetes care in hospital units before and after a randomised clinical trial (RCT) and international accreditation.

Design/methodology/approach: Interventional "before-after" study in 51 units (38 surgical and 13 anaesthetic) in nine hospitals participating in a RCT in the greater Copenhagen area; 27 of the units also underwent international accreditation.

Findings: The proportion of units with guidelines increased from 24/51 (47 percent) units before to 38/51 (75 percent) units after the trial. Among the 27 units without guidelines before the trial, significantly more accredited units compared to non-accredited units had a guideline after the trial (9/10 (90 percent) compared to 5/17 (29 percent). The quality of the systematic development scale and the clinical scales improved significantly after the trial in both accredited units (both p < 0.001) and in non-accredited units (both p < 0.02). The improvement of the systematic development scale was significantly higher in accredited than in non-accredited units (p < 0.01).

Originality/value: The combination of conducting both the DIPOM Trial and international accreditation led to a significant improvement of both dissemination and quality of guidelines on perioperative diabetic care.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation / standards*
  • Denmark
  • Diabetes Mellitus
  • Guidelines as Topic*
  • Humans
  • Internationality*
  • Perioperative Care
  • Practice Patterns, Physicians' / standards*
  • Quality Assurance, Health Care