How to make effective health recommendations-implications for coronial practice: a narrative review

We aimed to investigate the characteristics of health recommendations that are associated with implementation. In Aotearoa New Zealand many organisations and entities make recommendations. However, recommendations frequently fail to achieve traction. Guidance in the art of making effective recommendations is lacking.

A narrative literature review was conducted to search for evidence to guide recommendation making, primarily through identifying characteristics of recommendations that are implemented. This review focussed on recommendations that were made in the context of independent reviews, such as coronial inquiries, mortality review committees and royal commissions of inquiry, where there was a mandate to make recommendations.

There were many similarities in the recommendations that were more likely to be implemented across different settings. We identified factors associated with successful implementation across these areas, including factors associated with content, delivery, timing and relationships.

The quality and effectiveness of recommendations are important from both health and public policy perspectives, as there is a high opportunity cost to society when interventions that yield the highest health return on investment are not implemented. While the circumstances in which recommendations are made vary by setting and location, we believe that the issues explored in this paper have relevance to many settings where recommendations are made to improve health.