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Table 3 Implications of approaches to guideline implementation that differ by onus of responsibility

From: “More bang for the buck”: exploring optimal approaches for guideline implementation through interviews with international developers

Implications Responsibility
Developers Intermediaries Users
Pros · Continuity with development · Multiple mechanisms/roles: · User demand for instructions and tools
· There is no one else to implement guidelines Advise on tailoring of implementation · Lasting effect because instructions and tools always available once developed
Influence peers as champions · Feasible (easier, faster, least costly) so could be widely adopted
Assist with implementation
Cons · Insufficient resources are available with which to build capacity · Clinicians most suitable intermediaries but not likely to volunteer · Users have limited time to look at more information in guidelines
· Better to engage users in development and implementation · Resources needed to identify, compensate, train, and support them · Resources needed to develop instructions and tools