Center for Clinical Knowledge Management (CCKM) Clinical Policies

The Clinical Policy Program was established to provide a process for the development, approval, implementation, and routine multidisciplinary review of clinical policies. The program is intended to create consistent standards of care across all UW Health entities with the goals of improving quality and reducing cost in an evidence-based fashion.


UW Health Clinical Policy Committee


The UW Health Clinical Policy Committee provides oversight for UW Health clinical policies to promote consistent consolidated clinical policies that will guide care across the entities of the UW Health system - University of Wisconsin Hospitals and Clinics (UWHC), University of Wisconsin Medical Foundation (UWMF), the University of Wisconsin Department of Family Medicine and Community Health (UWDFMCH), and the University of Wisconsin School of Medicine and Public Health (UWSMPH).

  • Committee Chair: J. Scott McMurray, MD
  • Committee Vice Chair: Brian Arndt, MD

Committee Membership

  • Representation for UW Health and UWSMPH Legal Services
  • Risk Management director (or designee)
  • Representation from various specialties (Clinical Laboratory, Infection Control, Nutrition, Pharmacy, Radiology, Respiratory Therapy)
  • Medical Staff members from the 17 departments of the UWSMPH
  • Adult and Pediatric Nursing Representation from Ambulatory and Inpatient Settings
  • Advanced Practice Provider Representation
  • Surgical Services Representation
  • UW Health at The American Center Representation
  • House Staff Representation
  • Senior Management Representation (Senior Vice President Patient Care Service and Chief Nursing Officer designee, Senior Vice President and Chief Operating Officer designee, Chief Ambulatory Administrative Officer designee)
  • Director of Quality, Safety, and Innovation
  • Director of the Center for Clinical Knowledge Management
  • Information Services Representation
  • Graduate Medical Education Representation
  • Ad Hoc Compliance Representation

Clinical Policy Approval Process


All UW Health clinical policies must be approved by the UW Health Clinical Policy Committee. Clinical policies that contain content that affects physician practice must be approved by the Medical Board. Clinical policies approved by the UW Health Clinical Policy Committee (and Medical Board if necessary) will proceed for final approval by the UW Health Chief Medical Officer.