Related Experiment Video
Updated: Jun 3, 2026
06:05
The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
How can we improve guideline use? A conceptual framework of implementability.
Anna R Gagliardi1, Melissa C Brouwers, Valerie A Palda
1Departments of Surgery; and Department of Health Policy, Management and Evaluation; and Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. anna.gagliardi@uhnresearch.ca
Implementation Science : IS
|March 24, 2011
Summary
Clinical practice guidelines are underutilized. This study identified 22 implementability features to improve guideline use, but few current guidelines incorporate them, suggesting a need for modification to enhance decision-making support.
Area of Science:
- Implementation Science
- Health Services Research
- Clinical Practice Guidelines
Background:
- Clinical practice guidelines (CPGs) are often underutilized, with existing strategies to improve their uptake proving suboptimal.
- Modifying the inherent features of CPGs presents an alternative, yet largely untested, approach to enhance their use.
Purpose of the Study:
- To identify and define key features that enhance the implementability of CPGs.
- To assess the extent to which current CPGs incorporate these identified implementability elements.
Main Methods:
- Developed a comprehensive guideline implementability framework by synthesizing existing implementation science literature.
- Analyzed 20 high-quality CPGs from primary and institutional care, independently assessing them for the presence of implementability elements.
Main Results:
- The final implementability framework comprised 22 elements across eight domains (adaptability, usability, validity, applicability, communicability, accommodation, implementation, evaluation).
- Most analyzed CPGs contained extensive narrative evidence and tables but lacked features like alternate versions, patient engagement tools, resource implications, and local promotion guidance.
- No consistent trends in the inclusion of implementability features were observed across different guideline topics.
Conclusions:
- Significant opportunities exist to modify CPGs to better support diverse decision-making needs of various users.
- Development of new governance structures may be necessary to facilitate the creation of CPGs with enhanced implementability features.
- Further research is required to validate the implementability framework and evaluate the impact of incorporating these features on guideline use.
Related Concept Videos
01:11Guidelines for Writing Outcome
When developing expected outcomes for a patient care plan, the nurse should adhere to the following recommendations:
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care evaluation by...
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care evaluation by...
01:15Nursing Implementation
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:18Guidelines and Strategies for Safe Computer Charting
The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
Maintain Confidentiality and Security:
Maintain Confidentiality and Security:
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
Creating and executing a nursing diagnosis helps nurses plan care and guide patient, family, and community interventions. They are developed based on a patient's physical evaluation and support measuring the outcomes. It is not recommended to select random interventions throughout the planning process. Instead, consider the following six essential factors when choosing interventions: