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. 2016 Jun 29;4(3):36.
doi: 10.3390/healthcare4030036.

Barriers and Strategies in Guideline Implementation-A Scoping Review

Florian Fischer  1 , Kerstin Lange  2 , Kristina Klose  3 , Wolfgang Greiner  4 , Alexander Kraemer  5
Affiliations

Barriers and Strategies in Guideline Implementation-A Scoping Review

Florian Fischer et al. Healthcare (Basel). .

Abstract

Research indicates that clinical guidelines are often not applied. The success of their implementation depends on the consideration of a variety of barriers and the use of adequate strategies to overcome them. Therefore, this scoping review aims to describe and categorize the most important barriers to guideline implementation. Furthermore, it provides an overview of different kinds of suitable strategies that are tailored to overcome these barriers. The search algorithm led to the identification of 1659 articles in PubMed. Overall, 69 articles were included in the data synthesis. The content of these articles was analysed by using a qualitative synthesis approach, to extract the most important information on barriers and strategies. The barriers to guideline implementation can be differentiated into personal factors, guideline-related factors, and external factors. The scoping review revealed the following aspects as central elements of successful strategies for guideline implementation: dissemination, education and training, social interaction, decision support systems and standing orders. Available evidence indicates that a structured implementation can improve adherence to guidelines. Therefore, the barriers to guideline implementation and adherence need to be analysed in advance so that strategies that are tailored to the specific setting and target groups can be developed.

Keywords: barrier; guideline implementation; scoping review; strategy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the review.
Figure 2
Figure 2
Knowledge-Attitude-Behaviour Framework: Barriers and strategies to guideline implementation.
See this image and copyright information in PMC

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