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Thai) 2:
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incorporating the guidelines in routine procedures—such as quality assurance and review processes—of institutions and organisations that provide care;
• using information technology, particularly systems focusing on consultations with individual patients;
• arranging for a credible health care provider to visit practitioners in the clinical setting;
• piloting the draft guidelines in practices, clinics or hospitals, to facilitate assessment of their relevance, applicability, comprehensiveness and flexibility; and
• offering feedback on compliance with the guidelines.
Some of these strategies may be more effective when used in combination. There is evidence that the more educational the dissemination strategy, the greater the probability that the guidelines will be incorporated in clinical practice, provided that dissemination is reinforced by an appropriate implementation strategy.
The initial dissemination strategy should define target audiences and design accessible formats for the guidelines. Different versions of the guidelines should be developed for different audiences—consumers, general practitioners, specialist nurses, and so on. For example, the primary target audience for the National Health and Medical Research Council’s guidelines on the management of early breast cancer is consumers and specialists in breast surgery, medical oncology and radiation oncology; the secondary target audience is general practitioners, registered nurses involved in caring for women with breast cancer, funders, managers, accreditors and others.
Implementation strategies should take into account the ways in which privacy and confidentiality concerns might impede the implementation of guidelines. Questions raised by the need to manage patient care across several locations (hospitals, communities, nursing homes, and so on) or with the involvement of several clinicians need to be considered.
In summary, the group producing the guidelines should inform the target audience that the guidelines are being developed, let the audience know when they are available, ensure that they are distributed, and work with the audience on effective implementation.
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