OHSU Clinical Guidelines

When we integrate the best research evidence, clinical expertise and a patient's values and preferences, we can achieve higher-quality care, improve patient outcomes, reduce costs and see greater clinician and provider satisfaction. This is known as the quadruple aim.

OHSU is committed to creating a health system that supports these goals. This page contains information about how we develop and implement clinical guidelines that support a single standard of care for all providers who work within our system.

The Office of Clinical Integration and Evidence-based Practice oversees this work. Their mission is to:

  • Promote best practice and reduce undesirable practice variation.
  • Support clinical decision-making that leads to improved quadruple aim results
  • Develop an infrastructure that supports the delivery of value-based care, shifting focus from the volume of services delivered to the patient-centered outcomes achieved.
  • Establish accurate financial cost accounting of service programs, processes and care units.
  • Provide innovative teaching and research opportunities.


    Stages of guideline development

    The guideline development process begins with forming clinical questions (PICO), followed by searching, retrieving, appraising and summarizing the literature.

    OHSU critically appraises evidence and existing guidelines using the GRADE methodology and the University of Pennsylvania's Trustworthy Guideline Rating scale.

    Once developed, guidelines are approved by OHSU Health committees before we launch formal implementation teams. Then, we develop clinical decision support tools in the electronic health record.

    The implementation team works across OHSU Health to communicate and educate providers on clinical guideline updates. Additionally, we develop outcome and process metrics to ensure clinical updates are driving continuous improvement.

    OHSU Health develops patient-centered clinical outcomes as a part of each clinical guideline to ensure we are monitoring outcomes most relevant to the patient.

    • Identify topic for guideline development.
    • Form interprofessional guideline content team.
    • Determine guideline scope (PICOs, inclusion and exclusion criteria).
    • Search existing guidelines and literature.
    • Critically appraise evidence using GRADE criteria.
    • Present appraised findings to content expert team and develop practice recommendations.
    • Draft guideline, and establish outcome measures.

    Implementation and outcomes evaluation

    Implementation teams are formally launched once guideline has been approved across the health system. An Implementing Change model is used including:

    • Phase 1: Develop
    • Phase 2: Communicate
    • Phase 3: Educate/Train
    • Phase 4: Confirm
    • Phase 5: Sustain

    For more information on current guideline implementation status, please visit our OHSU Health Guidelines Implementation Tracking System

    Request our assistance

    Clinical groups and individual clinicians are invited to submit topic requests.

    The OHSU Health Clinical Integration Council is the governing body responsible for selecting and prioritizing guideline requests.

    Once topics have been identified, we ask content experts from each affiliated hospital to bring their clinical expertise to interpreting the evidence. This helps form practice recommendations and consensus statements that drive the development of the guideline and selection of outcome metrics.

    To request assistance from the Office of Clinical Integration and Evidence-based Practice, please complete the OHSU Health Guideline Proposal Form. If you have questions, email ebp@ohsu.edu.