University Health Network, Toronto, ON, Canada.
Implement Sci. 2012 Apr 2;7:26. doi: 10.1186/1748-5908-7-26.
Modifying the format and content of guidelines may facilitate their use and lead to improved quality of care. We reviewed the medical literature to identify features desired by different users and associated with guideline use to develop a framework of implementability and found that most guidelines do not contain these elements. Further research is needed to develop and evaluate implementability tools.
We are launching the Guideline Implementability Research and Application Network (GIRAnet) to enable the development and testing of implementability tools in three domains: Resource Implications, Implementation, and Evaluation. Partners include the Guidelines International Network (G-I-N) and its member guideline developers, implementers, and researchers. In phase one, international guidelines will be examined to identify and describe exemplar tools. Indication-specific and generic tools will populate a searchable repository. In phase two, qualitative analysis of cognitive interviews will be used to understand how developers can best integrate implementability tools in guidelines and how health professionals use them for interpreting and applying guidelines. In phase three, a small-scale pilot test will assess the impact of implementability tools based on quantitative analysis of chart-based behavioural outcomes and qualitative analysis of interviews with participants. The findings will be used to plan a more comprehensive future evaluation of implementability tools.
Infrastructure funding to establish GIRAnet will be leveraged with the in-kind contributions of collaborating national and international guideline developers to advance our knowledge of implementation practice and science. Needs assessment and evaluation of GIRAnet will provide a greater understanding of how to develop and sustain such knowledge-exchange networks. Ultimately, by facilitating use of guidelines, this research may lead to improved delivery and outcomes of patient care.
修改指南的格式和内容可以促进其使用，并提高护理质量。我们查阅了医学文献，以确定不同用户所期望的特征以及与指南使用相关的特征，从而制定了实施框架，并发现大多数指南并未包含这些要素。需要进一步研究来开发和评估实施工具。
我们正在启动指南实施可行性研究和应用网络（GIRAnet），以在资源影响、实施和评估三个领域开发和测试实施可行性工具。合作伙伴包括指南国际网络（G-I-N）及其成员指南开发者、实施者和研究人员。在第一阶段，将对国际指南进行检查，以确定和描述示例工具。特定适应症和通用工具将填充到可搜索的存储库中。在第二阶段，将使用认知访谈的定性分析来了解开发者如何最好地将实施可行性工具纳入指南，以及卫生专业人员如何使用这些工具来解释和应用指南。在第三阶段，将通过基于图表的行为结果的定量分析和对参与者访谈的定性分析，对实施可行性工具进行小规模试点测试，以评估实施可行性工具的影响。研究结果将用于规划对实施可行性工具的更全面的未来评估。
建立 GIRAnet 的基础设施资金将与合作的国家和国际指南开发者的实物贡献相结合，以增进我们对实施实践和科学的了解。GIRAnet 的需求评估和评估将更好地了解如何开发和维持这种知识交流网络。最终，通过促进指南的使用，这项研究可能会改善患者护理的提供和结果。
