Ethical and feasible stakeholder engagement in guideline development

Background: Stakeholder engagement impacts on the relevance and usability of guidelines. Consequently, guideline developers are advised to engage with a diverse group of stakeholders. One of the most critical and challenging phases of guideline development is determining the guideline scope, and there is currently scant guidance for how stakeholders can be engaged in feasible and ethical ways. 

Aim: This article aims to provide practical guidance for how diverse stakeholders can be engaged to determine the scope of a guideline. 

Methods: Supported by previous frameworks and by drawing on experiences from a research project aiming to develop a clinical practice guideline on non-pharmacological approaches for agitation in the intensive care unit, this paper describes a 7-step process for stakeholder engagement. Guideline developers need to consider the aim of their project, identify relevant stakeholders, decide on the level of engagement, plan how to engage in feasible and ethical ways, consider how to increase the trustworthiness of a project, and finally consider how to evaluate the project. 

Conclusion: Consultation of diverse stakeholder groups is feasible, but it is essential to plan the activities and be aware of the steps to take to ensure an effective and ethical process.