The effectiveness of clinical guideline implementation strategies – a synthesis of systematic review findings
Article first published online: 31 OCT 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Special Issue: Evidence Based Medicine
Volume 14, Issue 5, pages 888–897, October 2008
How to Cite
Prior, M., Guerin, M. and Grimmer-Somers, K. (2008), The effectiveness of clinical guideline implementation strategies – a synthesis of systematic review findings. Journal of Evaluation in Clinical Practice, 14: 888–897. doi: 10.1111/j.1365-2753.2008.01014.x
- Issue published online: 31 OCT 2008
- Article first published online: 31 OCT 2008
- Accepted for publication: 10 March 2008
- clinical guideline;
Objective To establish the effectiveness of clinical guideline implementation strategies.
Data sources/study setting Systematic reviews in full text, English language, 1987–2007, reporting any measure of clinical process change or cost–benefit analysis.
Study design Overview of secondary evidence
Data collection/extraction methods Independent critical appraisal using AMSTAR, primary author undertaking all data extraction using a purpose-built form.
Principal findings We identified 144 potential papers, from which 33 systematic reviews were included. These reflected 714 primary studies involving 22 512 clinicians, in a range of health care settings. Implementation strategies were varied, rarely comparable, with variable outcomes. Effective implementation strategies included multifaceted interventions, interactive education and clinical reminder systems. Didactic education and passive dissemination strategies were ineffective. Cost-effectiveness studies were rare.
Conclusions Successful guideline implementation strategies should be multifaceted, and actively engage clinicians throughout the process.