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Table 1 Guideline implementation planning checklist
| 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] |
