Article Figures & Tables
Tables
- Table 1: Summary of participant characteristics, by type of organization and GItool
Type of organization Type of GItool Total IM PE DM EV Professional society 1 5 1 3 10 Specialty foundation 4 2 3 3 12 Government agency 1 1 1 1 4 Total 6 8 5 7 26 Note: DM = point-of-care decision-making, EV = evaluation, IM = implementation, PE = patient engagement.
ID Type of GItool Country Type of organization Condition In or out of guideline Year published 01 IM Canada Foundation Mental health Out 2011 02 PE UK Foundation Diabetes Out 2010 03 DM Australia Foundation Congestive heart disease Out 2008 04 IM Australia Government Stroke In 2009 05 DM Canada Foundation Diabetes Out 2013 06 EV Canada Foundation Stroke Out 2008 07 DM Canada Government Hypertension In 2008 08 PE US Professional Head injury Out 2013 09 EV Germany Foundation Breast cancer Out 2008 10 IM Netherlands Foundation Generic Out 2012 11 EV Australia Government Neonatal health Out 2011 12 EV US Professional Prostate cancer Out 2013 13 IM Australia Foundation Stroke Out 2012 14 EV UK Foundation Stroke In 2010 15 EV UK Professional Skin disease In 2012 16 EV US Professional Head injury In 2013 17 PE Canada Foundation Depression In 2010 18 PE Netherlands Professional Physiotherapy Out 2013 19 PE Denmark Professional Urethral catheterization In 2013 20 PE Germany Professional Stroke Out 2013 21 IM Australia Foundation Stroke Out 2011 22 PE Finland Professional Osteoporosis Out 2008 23 DM US Professional Lung cancer Out 2013 24 PE Argentina Government Celiac disease Out 2011 25 PE US Professional Prostate cancer Out 2012 26 DM US Foundation Hypertension Out 2008 Note: DM = point-of-care decision-making, EV = evaluation, IM = implementation, PE = patient engagement.
• It’s usually a subgroup of the guideline development group (09-EV) • Three face-to-face meetings and the rest would be done over email (02-PE) • We’ll get a literature review to find out what the current evidence is (11-EV) • They provided examples [of other GItools] that really helped us (12-EV) • We did up a decision-matrix to decide on which elements should be included and why (04-IM) • The staff may review the very first draft, they tweak it and then send it to the co-chairs who have to sign-off on it (025-PE) • We got endorsement from [mentions several specialty societies] (04-IM) • Then they go to our designer, someone to put in the layout with the colours and photo images and then they’re proof-read once more and then published as PDF files to the website (08-PE) • We begin a communication plan. Who are the stakeholders that need to be aware of this material? How are we going to reach them? (023-DM) • There are individuals that are experts in this area of neurology but weren’t involved in the guideline development process (08- PE) • We try and get a closely related medical specialty society on the panel (08-PE) • Two senior implementation experts (10-IM) • We include a methodologist who’s capable of performance measure development (09-EV) • We have a staff person that’s dedicated to drafting the materials, liaising with others (08-PE) • An information specialist (01-IM) • We had two statisticians (10-IM) • It’s important also to have patient representatives on board (09-EV) • We had strong secretarial support to organize the meetings and teleconferences (13-IM) • We have a number of graphic designers…for the layout, colours, photo images (08-PE) • We have a communications person to craft the messaging (023-DM) • Those folks are experts in writing for right people (025-PE) • We don’t have extra resources to create these tools. We hand it off to the region (026-DM) • We didn’t have any budget for it apart from the printing budget (04-IM) • The office of the guideline and the members of the specialty societies work on a voluntary basis (09-EV) • We have one staff person that works full-time on this (08-PE) • We would reimburse them for travel to come to a meeting (12-EV) • Practices received $200 for participating in a pilot (03-DM) • The organization that funded it disseminated the tools (10-IM) • The societies will publish our tools in their newsletters (08-PE) • We have a big email group that we notify (11-EV) • It will be on our website (12-EV) • If we go to conferences we also bring print versions (022-PE) • We have an official launch (02-PE) • It’s under review in the [journal name] (10-IM) • We are going to actively recruit site champions (13-IM) • Now these indicators are incorporated into accreditation (06-EV) Step Considerations or tasks Prepare • Commence planning in conjunction with guideline development*
• Identify need by consulting with stakeholders, or collecting or analyzing data
• Select GItool that best addresses identified problem*
• Schedule and budget for 6 mo to 2 yr
• Partner with professional groups or researchers, or acquire research funding
• Resources required include staff (coordinator, graphic designer, editor, implementation expert) and operations (printing, communication, dissemination, travel reimbursement, conduct of systematic reviews, licenses)
• Establish a multidisciplinary Steering Committee of 10–15 individuals along with an administrative and clinical lead, plus relevant target users
• Specify expectations; ask individuals to declare conflicts of interest
• Others may be involved on Steering Committee or as needed (e.g., patients or advocacy groups, professional societies, informatics experts, public relations or marketing, technical writers)Plan • Steering Committee launch meeting
• Make decisions about format (i.e., paper or electronic, stand-alone or in guideline) and content (i.e., sources, length, graphics)*
• Use voting, rating or other consensus techniques for decision-makingCollect data • Identify existing GItools that could be adapted
• Collect data from various sources (i.e., guideline, review of published research)Develop a draft • Organize, synthesize and format collected data
• Refer to existing GItools as exemplars and to GItool Framework (14) to describe objectives, methods, evidence, evaluation and instructionsEngage target users • Consult with target users e.g., interviews, focus groups, survey)
• Incorporate target user feedback
• Steering Committee review meeting
• Incorporate Steering Committee feedbackPilot-test with target users • Consult with target users e.g., interviews, focus groups, observation, survey)
• Gather and summarize feedback on use and impact
• Incorporate target user feedbackFinal review and approval • Steering committee review meeting
• Incorporate Steering Committee feedback
• Final approval by Steering Committee, or other internal or external groupsEditorial • Proof, edit, translate to lay language, add graphics, refine layout Endorsement • Acquire endorsement by one or more professional bodies Implementation • Options include: dissemination by others (health regions, funders, professional societies; presentation at conferences or webinars; membership newsletters or email; websites or social media; distribute print material; mention of GItools in published guidelines; journal publications; local champions; incentives such as compensation, credits for continuing professional development or accreditation Evaluate use and impact • Conduct interviews, focus groups, observation, survey
• Build survey into GItool or website for prospective evaluation
• Engage others to more rigorously evaluate GItool use and impact*Steps or considerations that varied among participants and may require further research.
• You need to think about new tools and how you’re going to do it before you start writing the guideline (11-EV) • We conducted a national needs assessment of healthcare providers (05-DM) • We produce a patient version for every guideline now (02-PE) • It is helpful for any user if these documents can easily be found in one document (09-EV) • Don’t make these decisions and try to get them [target users] to agree to the decisions that you’ve made (04-IM)
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