The mission of the National Abortion Federation (NAF) is to ensure safe, legal, and accessible abortion care, which promotes health and justice for women. An important part of this work is to develop and maintain evidence-based guidelines and standards as well as to educate providers in the latest technologies and techniques. NAF’s programs make it possible for women to receive the highest quality abortion care.
Like its precursors, the 2013 edition of NAF’s Clinical Policy Guidelines (CPGs) establishes clinical policy guidelines, which are developed by consensus, based on rigorous review of the relevant medical literature and known patient outcomes. These guidelines are intended to provide a basis for ongoing quality assurance, help reduce unnecessary care and costs, help protect providers in malpractice suits, provide ongoing medical education, and encourage research.
NAF's Clinical Policy Guidelines, first published in 1996 and revised annually, are based on the methodology described by David Eddy, MD, in A Manual for Assessing Health Practices and Designing Practice Policies: The Explicit Approach. Clinical policy guidelines are defined as a systematically developed series of statements which assist practitioners and patients in making decisions about appropriate health care. They represent an attempt to distill a large body of medical knowledge into a convenient and readily usable format.
When the outcomes of an intervention are known, practitioner choices are limited. But when the outcomes of an intervention are uncertain or variable, and/or when patients' preferences for those outcomes are uncertain or variable, practitioners must be given flexibility to tailor a policy to individual cases. This is addressed by having three types of practice policies according to their intended flexibility: standards, recommendations, and options.
1) STANDARDS are intended to be applied rigidly. They must be followed in virtually all cases. Exceptions will be rare and difficult to justify.
2) RECOMMENDATIONS are steering in nature. They do not have the force of standards, but when not adhered to, there should be documented, rational clinical justification. They allow some latitude in clinical management.
3) OPTIONS are neutral with respect to a treatment choice. They merely note that different interventions are available and that different people make different choices. They may contribute to the educational process, and they require no justification.