Aboard the USS Bowfin (Pearl Harbor, Hawaii, United States of America). Personal collection.

Implementation of guidelines, officially

Reda SadkiGlobal health

This is everything that the World Health Organization’s Handbook for Guideline Development says about implementation. 

Implementation of a guideline should be taken into account right from the beginning of the guideline development. Implementation is generally the responsibility of national or subnational groups, which explains why their participation in guideline development is critical. WHO headquarters and regional and country offices can support implementation activities by promoting new guidelines at international conferences and providing guideline dissemination workshops, tools, resources and overall coordination [emphasis mine].

Implementation strategies are context-specific. The basic steps for implementing a guideline are:

  • convene a multidisciplinary working group to analyse local needs and priorities (looking for additional data on actual practice);
  • identify potential barriers and facilitating factors;
  • determine available resources and the political support required to implement recommendations;
  • inform relevant implementing partners at all levels; and
  • design an implementation strategy (considering how to encourage theadoption of the recommendations and how to make the overall context favourable to the proposed changes). Implementation or operational research can help inform field testing and rollout strategies to promote the uptake of recommendations.

There is a range of derivative documents or tools that can be developed to facilitate implementation. These can be distributed with the guideline, or local guideline implementers can develop them. Such documents or tools may include a slide set re ecting the guideline content; a “how to” manual or handbook; a flowchart, decision aide or algorithm; fact sheets; quality indicators; checklists; computerized applications; templates, etc.

Source: World Health Organization. WHO Handbook for Guideline Development, 2014.

Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.