Standards Development
Methodology for clinical guideline development. The clinical and organizational guideline was developed as a key
part of the improvement in the quality of care for women with PIH. While this case study focuses on the guideline development and dissemination, it must be understood within the context of the entire QI methodology used for the Quality
Assurance Project in Russia. The model for this QI project was based on Batalden and Stoltz’s framework for the continual
improvement of healthcare, which suggests the integration of clinical content knowledge and improvement knowledge as a powerful means of continual improvement in healthcare. The main principles of quality management were also applied in the development of the clinical guideline. These principles are a systems approach, teamwork, customer focus, and
scientific methodology. Based on this framework and the principles of quality management, Dr. Rashad Massoud of the
QA Project/URC-CHS developed a six-step methodology for developing clinical guidelines as an important part of improving
quality of care. (See Figure 1.)