Changing Professional Practice Theory and Practice of Clinical Guidelines Implementation

Health care professionals may have difficulties in keeping up-to-date with the overwhelming and fast growing volume of new scientific evidence for good clinical practice. Often there is an unacceptable time lag between the time of having a valid research basis for a specific procedure and the point when the procedure has been adopted in practice. This may lead to suboptimal care. Clinical guidelines are regarded as an appropriate vehicle for overcoming this. They can assist health care providers in grasping the new evidence and bring it into daily clinical routines. But the production and dissemination of clinical guidelines does not automatically improve clinical practice. For instance, some types of guidelines and some dissemination strategies seem more effective than others; the effectiveness can differ across settings; the providers' willingness to use a guideline may depend on who produced it etc. There is a broad spectrum of circumstances that should be taken into account. This book takes the reader through issues related to the introduction and use of clinical guidelines. In a multidisciplinary approach, it deals with concepts, methods, and theories relevant for studying the barriers and facilitators for the adoption of a guideline, the implementation process, the outcome, the costs etc. Topics covered include: • A framework for guidelines implementation studies • Design and statistical issues in implementation research • Economic evaluation • Qualitative approaches and methods • Identifying barriers and facilitators • Planning and monitoring interventions • Measuring attitudes towards clinical guidelines • A review of studies on perceived barriers and facilitators to implementation The book gives valuable information and tools for clinical guideline implementators and implementation researchers as well as for health policy decision-makers, purchasers, and providers. DSI • Danish Institute for Health Services Research and Development is an independent institution set up in 1975 by the state, The Association of Danish County Councils and Copenhagen and Frederiksberg municipalities. The institute's aim is to provide an improved basis for the work of the planning and management authorities within the health services. The publishing of extracts from this work, including figures, tables and quotes from the text, is permitted provided the source is clearly acknowledged. A copy of any work which makes reference to, reviews, quotes or refers the reader to this publication should be sent to: