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Implementing clinical guidelines: current evidence and future implications.

Jeremy Grimshaw1, Martin Eccles, Jacqueline Tetroe

  • 1Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario.

The Journal of Continuing Education in the Health Professions
|February 17, 2005
PubMed
Summary
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Translating research into practice remains a challenge. A systematic review found implementation strategies yield modest benefits, with no superior effect for multifaceted interventions over single ones.

Area of Science:

  • Health Services Research
  • Evidence-Based Practice
  • Implementation Science

Background:

  • Translating research findings into routine clinical practice is a persistent challenge in healthcare.
  • Previous systematic reviews on promoting research uptake faced methodological limitations.

Purpose of the Study:

  • To systematically review guideline dissemination and implementation strategies.
  • To assess the effectiveness of interventions in changing practitioner behavior and improving practice.

Main Methods:

  • Conducted a systematic review of studies on guideline dissemination and implementation.
  • Analyzed changes in practitioner behavior and calculated effect sizes across various interventions.

Main Results:

Related Experiment Videos

  • Implementation strategies led to desired practitioner behavior changes in 86% of comparisons.
  • The median effect size was approximately a 10% absolute improvement.
  • Both single and multifaceted interventions showed similar effectiveness; even seemingly less effective strategies had modest benefits.

Conclusions:

  • Evidence suggests that implementation strategies can achieve modest improvements in practice.
  • The evidence base is imperfect, with methodological weaknesses and poor reporting limiting generalizability.
  • Enhanced theoretical grounding is needed to improve the utility of implementation research.