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Field and Lohr make the important point that ‘guidelines do not implement themselves’ (1992). If guidelines are to be effective, their dissemination and implementation must be vigorously pursued. If not, the time, energy and cost devoted to the guidelines’ development will be wasted and potential improvements in consumer health will be lost.
A multidisciplinary panel should oversee the various steps needed to disseminate and implement the guidelines. The panel, which may be the same as the panel responsible for developing the guidelines, should also identify any barriers to the guidelines’ acceptance and implementation and work with members of target groups to develop ways of overcoming these barriers. Identifying barriers to change requires an understanding of sociological and psychological factors: it is essential that the guideline development panel has expertise in these areas; otherwise, inappropriate or ineffective methods of dissemination and implementation may be advocated.
Although the guideline document may support a specific strategy for adapting guidelines to local conditions, the guideline development panel may need to help local groups with the adaptation process.
There is evidence that a range of dissemination and implementation strategies can be effective (EHCB 1994). It is probable, however, that those strategies will depend on the nature of the guidelines and which group is being targeted. There are a number of possible strategies, such as the following:
• producing short summaries for use in a range of forums, including on the Internet and websites;
• involving potential users in the development of the guidelines, directly or through consultative mechanisms, or both, to promote ownership. The consultation process on the draft guidelines can form part of the dissemination strategy;
• using the media—local, regional or national, or a combination—to publicise both the development process and the availability of the guidelines;
• using professional journals and magazines to inform people about guideline development and promote the completed guidelines;
• using the communication links developed by clinical colleges, allied health organisations, specialty societies, State and regional medical societies, consumers, consumer groups, medical libraries and health education facilities;
• asking respected clinical leaders to promote the guidelines;
• providing economic incentives;
• using the educational processes of relevant colleges, professional organisations and consumer groups, including conferences, workshops, seminars and specialist journals;
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