Cleland and colleagues1 have analysed the data collected from the Burns Registry of Australia and New Zealand. The main purpose for the development of health care registries is to monitor and measure the effectiveness and quality outcomes of clinical care,2 thus enabling professionals to improve standards and treatments to patients by providing optimal care and management. The authors concluded that there was significant variation in management and outcomes of patients treated for severe and complex burn injury. They recommended further analysis and development of the registry in order to put in place clinical guidelines to improve the quality of care for patients with burn injury across Australia and New Zealand.1 While I agree with the importance of understanding the variations in practice and outcomes, it is also important to understand the authors’ definition of “evidence-informed clinical guidelines”, as implementing a practice that is too proscriptive or rigid may hinder the resilience of health care.
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- 1. Cleland H, Greenwood JE, Wood FM, et al. The Burns Registry of Australia and New Zealand: progressing the evidence base for burn care. Med J Aust 2016; 204: 195. <MJA full text>
- 2. Gliklich R, Dreyer N, Leavy MB, editors. Registries for evaluating patient outcomes: a user’s guide. Agency for Healthcare Research and Quality, 3rd ed. Rockville: Agency for Healthcare Research and Quality; 2014. Report no. 13(14)-EHC111. https://www.effectivehealthcare.ahrq.gov/ehc/products/420/1897/registries-guide-3rd-edition-vol-1-140430.pdf (accessed June 2016).
- 3. Wears RL. Resilience Healthcare Learning Network. Resilient procedures: oxymoron or innovation? Canadian Institutes of Health Research; 2015. http://resiliencehealthcarelearningnetwork.ca/blog/resilience-learning-network-teleconferencejanuaryblog2015 (accessed June 2016).
- 4. Cuschieri J, Johnson JL, Sperry J, et al. Benchmarking outcomes in the critically injured trauma patient and the effect of implementing standard operating procedures. Ann Surg 2012; 255: 993-999.
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