Appendix A - Governance

A1 Management framework for guideline development

Figure A.1 illustrates the management framework used to manage the development of the six modules of the guidelines, described in Section 1.2 of Chapter 1.

Figure A.1 Management framework for development of the guidelines [Click image for larger view]

ANZSBT, Australian & New Zealand Society of Blood Transfusion; CRG, Clinical/Consumer Reference Group; EWG, Expert Working Group; JBC, Jurisdictional Blood Committee; NBA, National Blood Authority; NHMRC, National Health and Medical Research Council

A2 Terms of reference

Steering Committee

The overarching Steering Committee was established to provide coordination and direction for development of the guidelines. It was chaired by the NBA, with representation from the ANZSBT, the NHMRC (including a member from the National Institute of Clinical Studies), a state expert and an expert from the Australian Government Department of Health and Ageing. The role of the Steering Committee was to:

• develop and oversee the project plan for the revision of the guidelines
• recommend the membership of the EWG to the NBA Chief Executive Officer, who will appoint the recommended members
• endorse the scope of the project as proposed by the EWG, and the process by which it will be undertaken
• ensure that there is effective communication and consultation with all relevant stakeholders for the duration of the project, including the development of a communications and engagement strategy that meets NHMRC requirements
• provide information through the NBA to the JBC on the project
• review resources that are dedicated to the project, to ensure that they are sufficient for the project to meet its deadlines
• review and approve revisions to the project plan and terms of reference
• address other matters as raised by members of the Steering Committee or EWG.

Expert Working Group

The EWG was formed to advise the Steering Committee about the scope and structure of the guidelines, and to determine the focus of the systematic review of the evidence-based literature. The group’s terms of reference were:

• to consider the scope of the project and proposed structure of the guidelines, as referred by the Steering Committee and, if necessary, to present recommendations for revisions to the Steering Committee
• under the guidance of the NHMRC GAR expert, to formulate the clinical questions to be answered by the literature review
• to provide clinical oversight for the development of the content of the guidelines, in particular, ensuring that:
  • the research undertaken is comprehensive
  • the quality of the revised guidelines will meet with clinical approval
• to provide recommendations on the terms of reference for the CRGs and oversee coordination of the activities of the CRGs
• to ensure appropriate engagement by consumers at all relevant points
• to assist in the development or review of tools and strategies to support the implementation and audit of the guidelines and review their uptake
• to facilitate consultation and the uptake of the guidelines
• to respond to any additional requirements to ensure compliance with the NHMRC guidelines development processes.

Systematic reviewers and technical writers

The NBA contracted systematic reviewers and technical writers to conduct systematic reviews of the scientific literature and provide technical writing services to produce each module and associated deliverables, including technical reports.

Clinical/Consumer Reference Groups

A CRG was formed to review each phase of the guidelines during development and, with the assistance of technical writers, to formulate recommendations aimed at optimising patient blood management based on systematic review findings, or, in the absence of evidence, to develop practice points through a consensus-based process. The CRG also provided advice to the EWG on guideline relevance and utility for targeted service providers and recipients who will use or benefit from the guidelines. Pertinent terms of reference for guidelines development included:

• the CRGs may review and offer advice on the set of questions to be put to the systematic review for the project
• the CRGs may review the draft guidelines and consumer materials, and offer advice on the way information is presented in terms of relevance and utility to the groups they represent
• the CRGs will not have authority or decision-making power over how that advice is used.

Guidelines Assessment Register expert

Two GAR experts were appointed by the NHMRC to provide advice and mentoring to the EWG and CRG, and to ensure that the new guidelines and the development process implemented by each reference group complied with NHMRC requirements.

A3 Membership of bodies involved in governance of the guidelines

Steering Committee

Dr Alison Turner (Chair)	National Blood Authority
Dr Heather Buchan	National Institute of Clinical Studies
Ms Cathy Clutton	National Health and Medical Research Council
Ms Vesna Cvjeticanin	National Health and Medical Research Council
Mr Ken Davis	Australian & New Zealand Society of Blood Transfusion
Prof Henry Ekert	Australian Government Department of Health & Ageing
Ms Sue Ireland	Jurisdictional Blood Committee
Dr Amanda Thomson	Australian & New Zealand Society of Blood Transfusion

Expert Working Group

Dr Craig French (Co-chair)	College of Intensive Care Medicine of Australia and New Zealand, and Australian & New Zealand Intensive Care Society
Dr Amanda Thomson (Co-chair)	Australian & New Zealand Society of Blood Transfusion
A/Prof Donald Bowden	Thalassaemia Australia
A/Prof Mark Dean	Haematology Society of Australia and New Zealand & Royal Australasian College of Physicians
Mr Shannon Farmer	Independent consumer advocate
Dr Chris Hogan	National Blood Authority
Ms Janine Learmont	Royal College of Nursing, Australia
Dr Helen Liley	Royal Australasian College of Physicians, Paediatric & Child Health Division
Dr Robert Lindeman	Royal College of Pathologists of Australasia
A/Prof Larry McNicol	Australian & New Zealand College of Anaesthetists
Prof John Olynyk	University of Western Australia Department of Medicine, Fremantle Hospital
Prof Michael Permezel	Royal Australian & New Zealand College of Obstetricians and Gynaecologists
Dr Kathryn Robinson	Australian Red Cross Blood Service
Dr Helen Savoia	Royal College of Pathologists of Australasia
Dr Richard Seigne	Australian & New Zealand Society of Blood Transfusion
Dr Philip Truskett	Royal Australasian College of Surgeons
Dr John Vinen	Australasian College for Emergency Medicine

Clinical/Consumer Reference Group for Phase 1

A/Prof Larry McNicol (Chair)	Anaesthetist	Australian & New Zealand College of Anaesthetists
Prof Zsolt Balogh	Trauma surgeon	Royal Australasian College of Surgeons
Mr Shannon Farmer	Consumer	Independent consumer advocate
Dr Craig French	Intensive care physician	College of Intensive Care Medicine of Australia and New Zealand, and Australian & New Zealand Intensive Care Society
Prof Russell Gruen	Trauma Surgeon	Royal Australasian College of Surgeons
Dr Chris Hogan	Haematologist	National Blood Authority
Dr Richard Seigne	Anaesthetist	Australian & New Zealand Society of Blood Transfusion
Mr Daryl Teague	Orthopaedic surgeon	Australian Orthopaedic Association
Dr Amanda Thomson	Haematologist	Australian & New Zealand Society of Blood Transfusion
Dr Philip Truskett	Surgeon	Royal Australasian College of Surgeons
Dr John Vinen	Emergency physician	Australasian College for Emergency Medicine

Background research

Dr Matt Chacko

Fellow in Anaesthesia, Austin Hospital( Supervisor A/Prof Larry McNicol)

National Health and Medical Research Council appointed Guidelines Assessment Register consultants

Ms Tracy Merlin	Adelaide Health Technology Assessment (AHTA), University of Adelaide
Ms Skye Newton	Adelaide Health Technology Assessment (AHTA), University of Adelaide

Project Management and Committee Secretariat – provided by the NBA

Ms Leia Earnshaw	Project Officer, Blood Sector Clinical Development
Dr Paul Hyland	Assistant Director, Blood Sector Clinical Development
Dr Dejan Krstik	Assistant Director, Blood Sector Clinical Development
Ms Jennifer Roberts	Director, Blood Sector Clinical Development

Systematic review team for questions 1–2 and 4–9

Dr Jane Adams	IMS Health Australia (Engagement Manager, Health Outcomes)
Mr Blaise Agresta	IMS Health Australia (Consultant, Health Outcomes)
Ms Miranda Bailey	IMS Health Australia (Senior Consultant, Health Outcomes)
Mr Laurence Fong	IMS Health Australia (Principal, Pricing and Market Access)
Dr John Gillespie	IMS Health Australia (Engagement Manager, Health Outcomes)
Ms Ann Jones	IMS Health Australia (Senior Medical Editor, Health Outcomes)
Ms Heather Phillips	IMS Health Australia (Consultant, Health Outcomes)
Dr Jodie Wilson	Independent contractor to IMS Health Australia
Ms Lavanya Vijayasingham	IMS Health Australia (Analyst, Health Outcomes)

Systematic review team for question 3

Dr Kristina Coleman	Health Technology Analysts (Principal Analyst)
Mr Gregory Merlo	Health Technology Analysts (Health Outcomes Analyst)
Dr Jonathon Tan	Health Technology Analysts (Health Outcomes Analyst/ Statistician)

Medical writing (module only) and technical editing – Health Technology Analysts

Dr Suzanne Campbell	Health Technology Analysts (Health Outcomes Manager)
Dr Adele Weston	Health Technology Analysts (Director)
Dr Hilary Cadman	Cadman Editing Services (independent contractor to Health Technology Analysts)

A4 Conflict of interest

All members of the Steering Committee, CRG and EWG declared any conflicts of interest before starting work on the guideline. Conflicts of interest were also reviewed at intervals, and were required to be declared at the start of each meeting. No conflicts of interest were declared, by any Steering Committee, CRG or EWG member, during the development of the Patient Blood Management Guidelines: Module 2 Perioperative.

A5 Acknowledgements

The CRG thanks the following, whose materials and advice were considered in developing the preoperative anaemia management algorithm template:

• the Western Australia Department of Health Patient Blood Management program
• the Medical Society for Blood Management
• the NBA Anaemia Management Working Group
• the Australian Iron Deficiency Expert Group.