Table 3 Implications of approaches to guideline implementation that differ by onus of responsibility
Implications | Responsibility | ||
|---|---|---|---|
Developers | Intermediaries | Users | |
Pros | · Continuity with development | · Multiple mechanisms/roles: | · User demand for instructions and tools |
· There is no one else to implement guidelines | ○ Advise on tailoring of implementation | · Lasting effect because instructions and tools always available once developed | |
○ Influence peers as champions | · Feasible (easier, faster, least costly) so could be widely adopted | ||
○ Assist with implementation | |||
Cons | · Insufficient resources are available with which to build capacity | · Clinicians most suitable intermediaries but not likely to volunteer | · Users have limited time to look at more information in guidelines |
· Better to engage users in development and implementation | · Resources needed to identify, compensate, train, and support them | · Resources needed to develop instructions and tools | |