Clinical Practice Guidelines (CPG) are commonly used healthcare tools that provide evidence-based and/or expert advice on managing clinical situations.  They draw on the best available evidence, are supplemented with clinical expertise and patient preferences, and provide guidance for the appropriateness of care being provided. While guidelines are helpful, there are numerous CPGs out there, some of which will vary slightly or may even contradict one another. In addition, they may not reflect local practice or account for local resources.   For these reasons, practitioners can be reluctant to use available CPGs and have asked for guidance from local consultatns on which CPGs they endorse for local use.

This has prompted a group of interested physicians and stakeholders to look at how CPGs could better support local Primary Care Practitioners (PCP) by providing access to clinically relevant, provincially endorsed for Saskatchewan's context.

SASK Guidelines are CPGs that have been reviewed, revised (if necessary) and endorsed by Saskatchewan consultants / experts as the most appropriate guideline for local use.  The primary audience for SASKGuidelines are SK physicians, nurse practitioners, and medical learners. Other audiences such as health educators, health authorities, allied health organizations, pharmacists, and nurses may also find them to be a useful resource.

Saskatchewan's inaugural CPG steering committee proposes to develop a sound, transparent methodology whereby Saskatchewan consultants / experts use a systematic review of clinical research and evidence to select and endorse CPGs for local use. 

The goal of this initiative is to make it easier to find CPGs that have been reviewed and endorsed by local consultants / experts.  

The inaugural steering committee is comprised of general practitioners, consultants, nurse practitioners, educators and other content area experts who are supported by the Ministry and the Canadian Agency for Drugs and Technologies in Health (CADTH).

The committee's guiding principles are:

  • To encourage appropriate responses to common medical situations.
  • To recommend actions that are sufficient and efficient, neither excessive nor deficient.
  • To permit exceptions when justified by clinical circumstances.

The primary goal of this Initiative is to improve primary care physicians and nurse practitioners access to provincially endorsed CPGs. CPGs are a guide to develop appropriate investigation and treatment plans for conditions that can be managed by a PCP who has access to the required resources.  This will be achieved through strong and integrated collaboration between primary care physicians, nurse practitioners and consultants.

The objectives of this Initiative are to:

  • Through collaboration of referring providers and consultants, review and endorse
    CPGs for the Saskatchewan context.
  • Improve access to provincially endorsed CPGs.
  • Provide direction to the referring providers and their patients in the management of patients' medical concerns, and when a referral may become necessary.
  • Through collaboration of referring providers and consultants, review and update the endorsed CPGs for the Saskatchewan context.

This will be achieved by:

  1. Identification of system barriers in the current state including access to CPGs, gaps in communication, quality improvement structures, physician workflow, etc.;
  2. Identification of a future state with improvement ideas and strategies to outline the outcomes that are to be achieved for better physician usage and access to CPGs, and patient care;
  3. Develop a standardized approach to select and implement provincially endorsed CPGs;
  4. Where possible, consolidate consultations into a single visit by improving the coordination, communication and collaboration of health professionals involved in the referral process;
  5. Providing support to the primary care team to help them make timely clinical decisions and to provide timely care to the patient;
  6. Leveraging existing technology and virtual care solutions  to improve physician workflow through easy  access to CPGs; Building on any other related  improvement initiatives; and,
  7. Creation of a sustainability plan for continuous quality improvement of the CPGs.

Success Criteria

Current SASKGuidelines Provincial Committee members: 
Physician Chair:
Dr. Kishore Visvanathan is a graduate of the College of Medicine at University of Saskatchewan, where he is now Clinical Professor of Surgery.  Since 1992, he has practiced urology in Saskatoon.  Kishore's interests are quality improvement and clinical practice redesign. He leads Saskatoon Urology Associates' Advanced Access project - an initiative to improve access to specialist consultation.

Kishore chairs Saskatchewan's Prostate Assessment Pathway, which expedites diagnosis and treatment for men suspected of having prostate cancer.  He is clinical lead for Saskatchewan's Improving Access to Specialist and Diagnostic care, a provincial initiative reducing wait times for specialty care.  Kishore teaches the principles and application of health care quality improvement to health care students and professionals at the University of Saskatchewan, and in conferences across Canada.

​​ Ministry of Health Co-Chair:
Andrea Fairbairn, Director, Strategic Priorities, Medical Services Branch, Ministry of Health. She and her skilled team are currently committed to improving access to specialty care and implementing virtual care technology across Saskatchewan.  

Project Lead:
Gaya Livingston, Project Manager, Strategic Priorities, Medical Services Branch, Ministry of Health, Government of Saskatchewan.
Contributing Members:
​Dr. Andrea Vasquez Camargo is originally from Colombia where she completed her medical school. She moved to Canada in 2005 and had the opportunity to do 4 years of General Surgery in the residency program at the University of Saskatchewan. She completed a Master of Science Degree at the University of Saskatchewan while transitioning into the Family Medicine Residency Program at the Regina site where she completed her training in 2016. She has been practicing as a Family Physician after joining the Family Medicine Unit in 2017 and is an Assistant Professor with the University of Saskatchewan Department of Academic Family Medicine. Currently she oversees the EBM curriculum in the Family Medicine Residency Program across the province of Saskatchewan. She also assists with the Surgical Skills curriculum, the minor procedure clinic and areas of Behavioral Medicine and Immigrant Health. 
​Ms. Cassandra Leggott started her career in rural Saskatchewan as a Primary Care Paramedic in 2005. She went on to complete her Bachelors in Nursing Science in 2009 and Advanced Certificate in Critical Care Nursing in 2010. She worked in Intensive Care in Regina and Saskatoon until she completed her Masters in Nursing in 2017, and began practicing as a Nurse Practitioner in Primary Care in Foam Lake. Cassandra is currently the President-elect of the Saskatchewan Association of Nurse Practitioners and serves as the provincial representative to the Nurse Practitioner Association of Canada. Cassandra recently began working seasonally as a Nurse Practitioner Clinical Facilitator at the University of Saskatchewan.
​Dr. Darcie McGonigle is a rural family physician in Île-à-la-Crosse, Saskatchewan where she also fills the roles of Physician Coordinator and Education Coordinator. She is an Assistant Professor with the University of Saskatchewan Department of Family Medicine, an Executive Board Member (Treasurer) of the Saskatchewan College of Family Physicians, a member of the University of Saskatchewan Postgraduate Rural Education Committee, and Chairperson of the SHA Practitioner Staff Review panel.
​Dr. Frankie Verville (she/her), a nurse practitioner, is the program head for the Collaborative Nurse Practitioner Program at Saskatchewan Polytechnic. She has has a Bachelors of Science in Nursing, a Masters of Nursing, a Post Graduate Diploma in Advanced Nursing Practice (Nurse Practitioner), and a Doctor of Nursing Practice. She has held various executive leadership positions including President of the Saskatchewan Association of Nurse Practitioners and is currently the President of the College of Registered Nurses Association. Her research interests include advanced practice nursing and knowledge translation of research into practice and the influence of these variables on patient outcomes. In addition to her academic work, Frankie maintains a primary care clinical practice in rural communities and long term care.
​Ms. Janet Luimes is a primary care nurse practitioner and assistant professor with the University of Saskatchewan College of Nursing. She maintains an active clinical practice in preventative health care, with a special interest in pediatric and young adult mental health.
CADATH, Saskatchewan Division, an independent, not-for-profit organization responsible for providing health care decision-makers with objective evidence to help make informed decision about the optimal use of health technologies. CADTH provides evidence and implementation support to SaskGuidelines.
​Ms. Michelle O'Keefe is a Nurse Practitioner working with the Saskatchewan Health Authority at the Indian Head Primary Health Care Centre in Indian Head, SK. She obtained her Bachelor of Nursing from Memorial University of Newfoundland in 2006, followed by her Masters of Nursing in Advanced Nursing Practice from Athabasca University in 2013. Since then, she had been working as a Primary Health Care Nurse Practitioner with her practice consisting of acute patient presentations, chronic disease management, mental health, women's health, and well child growth and development. She currently sits on the Saskatchewan Association of Nurse Practitioners Executive Board as the Education Chair.
​Dr. Myles Deutscher B. Eng., M.D. CCFP., FCFP. Grew up in Meadow Lake Saskatchewan. Obtained his MD from the University of Saskatchewan and completed Family Medicine Training in Saskatoon, SK. Has been practicing urban Family Medicine in Saskatoon SK since 2009. President of the Saskatchewan College of Family Physicians (2020 - 2022).
Ms. Tara Schmalenberg is a primary care nurse practitioner in rural Saskatchewan. Graduating from the Collaborative Nurse Practitioner Program in 2018, Tara maintains clinical practices in the communities of Raymore and Lestock. Her areas of interest include chronic disease management and patient education. Outside of her clinical practice, Tara is a sessional nursing instructor with the University of Regina. Additionally Tara is the president of the Saskatchewan Association of Nurse Practitioners and a member of the Nurse Practitioner Advisory Group with the College of Registered Nurses of Saskatchewan. ​ ​

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