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


Gagliardi BMC Health Services Research 2012 12:404   doi:10.1186/1472-6963-12-404

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