At Quest, we identify medicine as evidence-based when it has shown there is a health benefit. Quality Quest has chosen to follow guidelines established by the Institute for Clinical Systems Improvement (ICSI). Since its start in 1993, ICSI has worked in Minnesota to improve patient care by promoting evidence-based medicine. ICSI is a non-profit organization that’s comprised of 57 medical groups and sponsored by six Minnesota and Wisconsin health plans. A team of medical experts developed best-practice guidelines for many medical conditions based on what was known about their value. ICSI categorizes guidelines on two levels, best evidence and good evidence, and includes a third level of services that have incomplete evidence. These guidelines are updated yearly based on new practices and information.

Using guidelines provides benefits for patients, physicians and insurance companies. Patients know they are receiving care that in beneficial. Physicians use guidelines to know the best course of treatment for their patients and to achieve good patient outcomes. Insurance companies and other payers know that their members are getting the best care for their needs.

Medical guidelines are developed by experts who methodically review the scientific literature and synthesize all available information into documents detailing clinical recommendations. They are like an operators’ manual for healthcare. Who writes the guidelines makes a difference. It is important that all conflicts of interest be fully disclosed. The best guidelines are developed by independent teams comprised of individuals with varied clinical backgrounds, using standardized processes.

Healthcare guidelines are nothing new. What is new is the recognition that agreement on the best care is the first step towards getting better results. Guidelines alone do not ensure that the goal of the right patient getting the right care at the right time is reached. More steps are needed, like checklists, teamwork and standardized protocols. Airline safety depends on checklists. Patient safety does too.

Every patient is different, and sometimes the science isn’t clear. Patients, with their doctors, need to decide what is best for them. When the evidence is clear, and it is in more and more instances, guidelines help doctors and nurses do a better job.

Quality Quest for Health of Illinois is proud to lead the way in changing healthcare in Illinois. By following medical guidelines and practicing evidence-based medicine, we will see a change in the value and quality of care we receive.