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Clinical guidelines online: do they improve compliance?
J G Williams1, W Y Cheung, D E Price
1The Clinical School, University of Wales Swansea, Singleton Park, Swansea SA2 8PP, UK. j.g.williams@swan.ac.uk
Postgraduate Medical Journal
|July 16, 2004
Summary
Making clinical guidelines available online improved adherence for stroke care but not for deep vein thrombosis or upper gastrointestinal bleeding. Active promotion and consensus are key for online guideline effectiveness.
Area of Science:
- Medical Informatics
- Clinical Practice Guidelines
- Health Services Research
Background:
- Intranet services in hospitals offer opportunities to disseminate evidence-based guidelines.
- Facilitating access to online guidelines can promote best practices in acute medical care.
Purpose of the Study:
- To evaluate the effectiveness of making national medical guidelines available online.
- To assess the impact on adherence to acute medical care guidelines.
Main Methods:
- An interrupted time series design was employed to analyze guideline compliance.
- Three specific guidelines (deep vein thrombosis, upper gastrointestinal bleeding, stroke) were evaluated.
- Qualitative interviews assessed medical staff perceptions.
Main Results:
- Significant increase in adherence to stroke management guidelines after online availability.
- No demonstrable improvement in adherence for deep vein thrombosis or upper gastrointestinal bleeding guidelines.
- Staff confusion and lack of support impacted adherence for some guidelines.
Conclusions:
- Online availability alone is insufficient for guideline implementation.
- Active promotion and consensus among healthcare professionals are crucial for effective online guideline adoption.