Introduction on guideline implementation guidance
How to enhance the implementation of guidelines?
In recent years, more and more guidelines for health professionals have been developed, but the degree of implementation in a variety of contexts can be influenced by several factors:
- Complexity: Guidelines will often be more successful if they can easily be understood and tried out and do not require specific resources.
- Scientific base: Adherence to guidelines tends to be higher if the guidelines are evidence-based.
- Involvement of target groups: It might improve the chance of successful implementation if guidelines are developed by or in co-operation with the targeted professionals.
Apart from these aspects, environmental characteristics have an impact on the implementation of guidelines. Support by peers or superiors, sufficient staff and time can for example enhance the chance of successful implementation. Besides, implementation strategies tend to be more effective if they have multiple components, instead of using one single strategy, like reminders or one educational intervention only. Guideline developers should take these aspects into account in order to increase the chance that a guideline will actually be used.
How to enhance the implementation of interventions?
In order to achieve improvements in health it is of key importance to support and promote the uptake of evidence-based interventions. Many interventions are developed and implemented in academic settings but are less often successfully implemented in community-based institutions. It is thus important to close the gap between research and practice and to strengthen co-operation between researchers, policy makers and other stakeholders in order to improve the uptake of research findings.
When developing interventions it is essential to take the following aspects into account:
Interventions that are developed based on existing theories and (scientifically) tested approaches are more successful in realising behavioural change in individuals and organisations than those that have not.
Interventions should consider the diversity of populations and the contextual differences in European countries and settings. In addition, it is important to adapt interventions to specific contexts.
To enhance the implementation of interventions it is also important to improve fidelity to the intervention and to provide guidance for implementing the interventions in a cost-efficient manner.
What makes health literacy policies effective?
Effective health literacy policies can have great impact and can improve public health. Amongst others, the following aspects are important for effective health literacy policies:
- Effective health literacy policies should promote scientific approaches in achieving personal and organisational change. Moreover, they should incorporate scientific evaluation and learning from experiences.
- Promoted interventions in policies should be coherent; should aim for objectively measurable effects, enabling further development of theoretical concepts which feed into further policy development.
- To be effective, health literacy policies have to take heterogeneity of cultures, ethnic groups, socio-economic conditions and healthcare systems within the European Union into account.
- Effective health literacy policies need to be adapted to local circumstances.
Health literacy should be incorporated in all policies in healthcare and healthy aging read more here. These policies should enable people to take decisions about their own health and cope with their health issues, including people who face difficulties in this regard.
Francke A, Smit M., de Veer A., Mistiaen P. (2008) Factors influencing the implementation of clinical guidelines for healthcare professionals: A systematic meta-review. BMC Medical Informatics and Decision Making, 8:38 doi: 10.1186/1472-6947-8-38. Download PDF here
Kilbourne A., Neumann M., Pincus H., Bauer M., Stall R. (2007) Implementing evidence-based interventions in healthcare: application of the replicating effective programs framework. Implementation Science, 2:42 doi:10.1186/1748-5908-2-42. Download PDF here