Background Evidence-based guidelines should be developed with rigorous methodological standards such as described by AGREE, G-I-N and IOM. One of the main aims is that the development process is repeatable and transparent. To follow these principles, process descriptions and methodological handbook are needed to enable appraisal.

Context Our organisation has developed EBM guidelines for two decades. A methodological handbook was first published in 1998, with the latest (6th) revision published in 2012. Until 2012, processes have been described as simple flowcharts, covering mainly the work phases, not the whole process.

Description of Best Practice Handbook was revised in co-operation with other national EBM organisations. It describes composition of guideline development group, methods for developing a guideline, consensus methods and decision-making process, patient involvement, peer review methods, and updating procedure. The process description was initiated in a workshop where all work phases and activities of guideline development process were written down and placed on a process flow diagram (swimlane) in chronological order. At the same time, the performer for each activity was acknowledged. Subsequently, main phases of the process were identified and described as subprocesses. The software used enabled linking between subprocess descriptions which made it possible to build up an overall picture of the process.

Lessons for Guideline Developers, Adaptors, Implementers, and/or Users Visualising the overall picture of the process enables understanding of responsibilities of different performers in chronological order. Explicit process descriptions increase transparency, facilitate future process development, and help to maintain the rigorous guideline standards.