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Table 1 Guideline implementation planning checklist

From: Developing a checklist for guideline implementation planning: review and synthesis of guideline development and implementation advice

Steps or considerations References
Implementation planning—instructions for when and how to plan and prepare for implementation
Implementation should be considered at the beginning, and throughout the guideline development process [26-29]
Form an implementation team from the start that includes stakeholders (patient groups, end users, champions, relevant organizations and agencies, policy-makers) and one or more knowledge translation experts [26-28,30-33]
Identify and assemble resources for implementation [27,34]
Audit current practice as a baseline needs assessment [32]
Consider or assess barriers of guideline implementation and use (patient, professional, organizational, system, economic, political, social/cultural), and stakeholder needs and preferences through literature review, observation, focus groups, interviews or survey [27,30-39]
Consider dissemination and/or implementation on a recommendation-by-recommendation basis rather than for entire guideline [33]
Determine the dissemination and implementation strategies that are effective and best suited to address identified needs and barriers [27,30-36,40]
Determine what implementation tools will be developed based on: guideline scope; guideline recommendations; identified knowledge gaps or baseline audit; interviews or focus groups with guideline users [30,35,40,41]
Develop an implementation plan describing dissemination and implementation strategies and tools, roles and responsibilities, milestones, time frames, and implementation measures [26-28,32,38,42]
Consider pilot testing the implementation strategy on a small scale and adjust as needed after the pilot test and on an ongoing basis [32,34,38]
Continue to engage stakeholders with outreach and education throughout the guideline development process [27,30-33,40]
Ensure guideline recommendations are implementable and can be integrated in computer decision support systems [35,41]
Implementation tools—instructions for developing guideline content, versions, or tools that support implementation
Research potential designs for type(s) of tools selected [30]
Identify resources that will be needed [30]
Present draft tool to guideline development group [30]
Refine the tool with feedback, and several iterations may be needed [30]
Test tool usability with clinician or patient interviews or focus groups [30]
Feedback is used to refine the tool [30]
Final version is reviewed by the guideline development group [30]
Implementation tools are published at the same time as the guideline [26]
Potential implementation tools include:  
Versions in different languages [27,28,43]
Versions in different formats (mobile devices, pocket guide, wall poster) [26,29-31,44-47]
Summary versions (short version, recommendations only, evidence only) [26,28,29,32,35,37,38,42-44,46-51]
Patient or plain language version [26,27,35,43,46,48,49]
Point-of-care tools (algorithms, checklists, decision aids) [27,28,35,36,38,48-50,52]
Electronic medical record/computer decision support system integration [30]
Implementation plan (recommended strategies, barriers specific to the guideline and its recommendations, instructions) [28,36,43,48,53,54]
Teaching aids (slide set, case examples, meeting agenda) [27,42,47,49,52,53]
Patient and caregiver resources [28,32,35,36,45,48,50,52]
Resource planning guide (human, infrastructure, technological capacity needed to implement and apply the recommendations) [36,48]
Costing tools (spreadsheet, report templates) [26,53]
Evaluation plan (instructions, measures, data collection instruments) [26-28,32,35,36,39,45,48,50,53]
Dissemination and implementation—strategies for distributing, sharing, promoting and applying guideline recommendations
Dissemination options include:  
Web site (guideline, implementation tools, accredited CPD modules) [26,27,29,32,35,38,43-49,51,55-58]
Journal publications (which can link to online material) [26,27,29,30,35,37,42-49,51,55-57,59,60]
Press release [31,35,47,49]
Mass media campaign [27,30,32-34,41]
Email distribution [35,44,49]
Podcast or webinar [35,45]
Register with AHRQ Guideline Clearinghouse and G-I-N Library [35]
Partnerships (national organizations, networks) [26,31,45]
Endorsement by specialty society [31,45]
Marketing strategies [31]
Traditional arts [31]
Implementation options include:  
Printed educational material [31-34,36,40,41]
Educational meetings (conferences, workshops, CPD) [26,30-36,39-42,44,46,60]
Educational outreach/Academic detailing [32-34,36,40,41,60]
Local opinion leaders [32-34,36,40,41,60]
Audit and feedback [32-34,36,40-42,60]
Reminders [32,33,36,39-41,60]
Multi-faceted interventions [32,36]
Patient-mediated interventions (educational material, decision support tools, mass media campaign, reminders) [32-43,40]
Organizational interventions (revision of professional roles or teams, leadership engagement) [33,34,40]
Financial incentives or penalties [32,33,41]
Computer decision support systems [33,41]
Regulatory interventions/accreditation [33,41,42]