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Expert Rev Pharmacoecon Outcomes Res. 2011 Jun;11(3):315-24. doi: 10.1586/erp.11.32.

Better guidelines for better care: enhancing the implementability of clinical practice guidelines.

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Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, 209 Victoria Street, 6th floor, Toronto, Ontario, Canada.


The potential of clinical practice guidelines to promote evidence-based care has not been consistently realized. This article outlines how modifying guidelines, and specifically their implementability (the perceived characteristics that influence their use in practice), could be an inexpensive way to improve care. The article uses a planned action model, Graham's knowledge-to-action framework, to illustrate how this framework can be applied in the context of an ongoing research initiative. It describes each step from knowledge synthesis, to barrier analysis, intervention development and evaluation of a guideline implementability tool that could facilitate uptake of guidelines in clinical practice. This tool targets guideline developers, so that better guidelines may result in better care.

[Indexed for MEDLINE]

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