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063 Enhancing the Uptake of Clinical Practice Guidelines: The Development of a Guideline Implementability Tool (Guide-It)
  1. M Kastner,
  2. J Versloot,
  3. L Hayden,
  4. A Chatterjee,
  5. O Bhattacharyya
  1. Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Canada

Abstract

Background Guidelines have the potential to facilitate implementation of evidence into practice but this has not been consistently achieved. We developed a guideline implementability tool (GUIDE-IT), which can assess the implementability of guideline recommendations.

Objective To determine if GUIDE-IT can improve the Language and Format of guideline recommendations.

Methods Using a mixed-methods approach to develop GUIDE-IT, we conducted 1) a Realist Review of guideline factors influencing uptake, and used its results to build a conceptual model of guideline implementability; 2) qualitative interviews with 20 family physicians to determine factors influencing guideline uptake and to obtain input on tool design; 3) created a prototype and conducted validity assessments with experts in guideline development and human factors. GUIDE-IT was then pilot tested with the Canadian Diabetes/Paediatric Associations (CDA, CPS) to determine its potential for assessing the implementability of guideline recommendations.

Results Pilot testing with CDA and CPS developers showed that factors across 4 sub-domains of Language (clarity, simplicity, specificity, and actionability) and 3 sub-domains of Format (presentation, components, and multiple versions) were applicable for modifying recommendations. GUIDE-IT was feasible to use by guideline developers to identify implementability problems and to improve recommendations.

Discussion GUIDE-IT is based on a robust evidentiary base with the potential to improve guidelines. Next steps include evaluating GUIDE-IT in a controlled trial to determine its impact on end-user clinical decision making.

Implications for Guideline Developers/Users GUIDE-IT has potential to be a practical tool for developers to improve the language and format of guideline recommendations.

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