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Implementation plans included in World Health Organisation guidelines

机译:世界卫生组织的实施计划包括在世界卫生组织指导方针

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The implementation of high-quality guidelines is essential to improve clinical practice and public health. The World Health Organisation (WHO) develops evidence-based public health and other guidelines that are used or adapted by countries around the world. Detailed implementation plans are often necessary for local policymakers to properly use the guidelines developed by WHO. This paper describes the plans for guideline implementation reported in WHO guidelines and indicates which of these plans are evidence-based. We conducted a content analysis of the implementation sections of WHO guidelines approved by the WHO guideline review committee between December 2007 and May 2015. The implementation techniques reported in each guideline were coded according to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) taxonomy and classified as passive, active or policy strategies. The frequencies of implementation techniques are reported. The WHO guidelines (n?=?123) analysed mentioned implementation techniques 800 times, although most mentioned implementation techniques very briefly, if at all. Passive strategies (21?%, 167/800) and general policy strategies (62?%, 496/800) occurred most often. Evidence-based active implementation methods were generally neglected with no guideline mentioning reminders (computerised or paper) and only one mentioning a multifaceted approach. Many guidelines contained implementation sections that were identical to those used in older guidelines produced by the same WHO technical unit. The prevalence of passive and policy-based implementation techniques as opposed to evidence-based active techniques suggests that WHO guidelines should contain stronger guidance for implementation. This could include structured and increased detail on implementation considerations, accompanying or linked documents that provide information on what is needed to contextualise or adapt a guideline and specific options from among evidence-based implementation strategies.
机译:高质量指南的实施对于改善临床实践和公共卫生至关重要。世界卫生组织(世卫组织)制定基于证据的公共卫生和世界各国各国使用或改编的其他指导方针。当地政策制定者常常需要详细的实施计划,以适当地使用世卫组织开发的指南。本文介绍了在世卫组织指导方面报告的指南实施计划,并表明这些计划中的哪一个是基于证据的。我们对世卫组织指南审查委员会于2007年12月至2015年5月批准的世卫组织指南审查委员会进行了内容分析。根据Cochrane协作的有效实践和保育组织(EPOC)分类,在每个指导方案中报告的实施技术进行了编码并归类为被动,主动或政策策略。报告了实现技术的频率。虽然大多数情况下,虽然大多数情况下,虽然大多数情况非常简单地,但是,谁的指导方针(n?=?123)分析了提到的800次的实现技术。被动策略(21?%,167/800)和一般政策策略(62?%,496/800)最常发生。通常忽略了基于证据的主动实施方法,没有提及提醒(计算机化或纸张),只有一个提及多方面的方法。许多指导方针包含了与由同一指南所使用的技术单位产生的那些相同的实施部分。与基于证据的活跃技术相反的被动和基于政策的实施技术的普遍性表明,世卫组织指南应包含更强的实施指南。这可能包括在执行考虑因素,随附或链接文件中提供有关上下文的执行策略中所需的信息的陪同或联系文件的结构化和相关文件。

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