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The effectiveness of clinical guideline implementation strategies – a synthesis of systematic review findings
Author(s) -
Prior Mathew,
Guerin Michelle,
GrimmerSomers Karen
Publication year - 2008
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2008.01014.x
Subject(s) - guideline , data extraction , psychological intervention , medicine , systematic review , critical appraisal , medical education , process (computing) , health care , medline , alternative medicine , process management , nursing , computer science , pathology , business , political science , law , economics , economic growth , operating system
Objective To establish the effectiveness of clinical guideline implementation strategies. Data sources/study setting Systematic reviews in full text, English language, 1987–2007, reporting any measure of clinical process change or cost–benefit analysis. Study design Overview of secondary evidence Data collection/extraction methods Independent critical appraisal using AMSTAR, primary author undertaking all data extraction using a purpose‐built form. Principal findings We identified 144 potential papers, from which 33 systematic reviews were included. These reflected 714 primary studies involving 22 512 clinicians, in a range of health care settings. Implementation strategies were varied, rarely comparable, with variable outcomes. Effective implementation strategies included multifaceted interventions, interactive education and clinical reminder systems. Didactic education and passive dissemination strategies were ineffective. Cost‐effectiveness studies were rare. Conclusions Successful guideline implementation strategies should be multifaceted, and actively engage clinicians throughout the process.