Breaking the Chains of Clinical Practice Guidelines: Could SCAMPs Be the Answer?

I have written extensively about the challenges in driving better outcomes in our patients with advanced CKD and ESRD. Not the least of these is the continued reliance of clinicians, payers and regulators on clinical practice guidelines (CPGs) to determine what domains are worthy of focus for public reporting and for payment to dialysis facilities. Unfortunately, however, the CPGs in nephrology are small in number and, despite excellent performance across the ESRD population on overall, we have not moved the needle on the really important primary outcomes that will ultimately result in better lives for our patients: lower mortality, fewer hospitalizations and an improved experience of care.

A recent article in Health Affairs described a different approach to achieving the goals for which we all strive—the use of standardized clinical assessment and management plans (SCAMPs), “a clinician-designed approach to promoting care standardization that accommodates patients’ individual differences, respects providers’ clinical acumen, and keeps pace with the rapid growth of medical knowledge.”(1) This approach was developed and has been applied largely by pediatricians as an outgrowth of their frustration with CPGs. Nearly 50 SCAMPs have been developed, and more than 12,000 patients currently are enrolled in SCAMP programs. Read more…