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Erschienen in: Pediatric Surgery International 9/2020

25.06.2020 | Original Article

Barriers to the implementation of new guidelines among pediatric surgeons: online survey

verfasst von: Abdulraouf Lamoshi, A. Gibbons, S. Williams, T. Ponsky

Erschienen in: Pediatric Surgery International | Ausgabe 9/2020

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Abstract

Purpose

To identify barriers that prevent pediatric surgeons from implementing updated practice guidelines.

Methods

An online survey targeting pediatric surgeons was conducted on the StayCurrent MD Application (SCMA) and Pediatric Surgery Education Facebook page (PSE FBP). The survey results for pediatric surgeons of underdeveloped countries (PSUC) and pediatric surgeons of developed countries (PSDC) was compared and analyzed.

Results

Based on the number of active members on PSE FBP and SCA, the response rate was 32.3% (174/539), 66.3% of responses were from PSUC. The majority of PSUC (73%) wanted to have convincing guidelines and the plurality of PSDC (46%) wanted to see approval by the American Pediatric Surgical Association (APSA) for implementation of new guidelines. Lack of resources was the number one response (78%) for PSUC not implementing the most up to date guidelines and about 40% of the PSDC responded “concerned about malpractice liability.”

Conclusions

PSUC and PSDC identified very different barriers to implementation of new guidelines. It is reassuring that accessibility to treatment is not the primary issue, though resistance to implementation is a resounding concern. Identifying the barriers will highlight areas that need to be addressed, and awareness may help resolve some of the barriers.
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Literatur
1.
Zurück zum Zitat Filed MJ, Lohr KN (eds) (1990) Clinical practice guidelines: directions for a new program. National Academy Press, Washington, DC Filed MJ, Lohr KN (eds) (1990) Clinical practice guidelines: directions for a new program. National Academy Press, Washington, DC
2.
Zurück zum Zitat Grol R, Grimshaw J (2003) From best evidence to best practice: effective implementation of change. Lancet 362:1225–1230PubMedCrossRef Grol R, Grimshaw J (2003) From best evidence to best practice: effective implementation of change. Lancet 362:1225–1230PubMedCrossRef
3.
Zurück zum Zitat White AT, Clark CM, Sellick JA, Mergenhagen KA (2019) Antibiotic stewardship targets in the outpatient setting. Am J Infect Control 47(8):858–863PubMedCrossRef White AT, Clark CM, Sellick JA, Mergenhagen KA (2019) Antibiotic stewardship targets in the outpatient setting. Am J Infect Control 47(8):858–863PubMedCrossRef
4.
Zurück zum Zitat Shawyer AC, Hatchell AC, Pemberton J, Flageole H (2015) Compliance with published recommendations for postoperative antibiotic management of children with appendicitis: A chart audit. J Pediatr Surg 50(5):783–785PubMedCrossRef Shawyer AC, Hatchell AC, Pemberton J, Flageole H (2015) Compliance with published recommendations for postoperative antibiotic management of children with appendicitis: A chart audit. J Pediatr Surg 50(5):783–785PubMedCrossRef
5.
Zurück zum Zitat Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma 2008 update. Allergy 63:8–160PubMedCrossRef Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma 2008 update. Allergy 63:8–160PubMedCrossRef
6.
Zurück zum Zitat Francke AL, Smit MC, de Veer AJE, Mistriaen P (2008) Factors influencing the implementation of clinical guidelines for healthcare professionals: a systematic meta-review. BMC Med Inf Decis Mak 8:38CrossRef Francke AL, Smit MC, de Veer AJE, Mistriaen P (2008) Factors influencing the implementation of clinical guidelines for healthcare professionals: a systematic meta-review. BMC Med Inf Decis Mak 8:38CrossRef
7.
Zurück zum Zitat Grilli R, Lomas J (1994) Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Med Care 32:202–213PubMedCrossRef Grilli R, Lomas J (1994) Evaluating the message: the relationship between compliance rate and the subject of a practice guideline. Med Care 32:202–213PubMedCrossRef
8.
Zurück zum Zitat Rogers EM (1995) Lessons for guidelines from the diffusion of innovation. Jt Comm J Qual Improv 21:324–328PubMed Rogers EM (1995) Lessons for guidelines from the diffusion of innovation. Jt Comm J Qual Improv 21:324–328PubMed
9.
Zurück zum Zitat Carlsen B, Norheim OF (2008) ‘What lies beneath it all?’: an interview study of GP’s attitudes to the use of guidelines. BMC Health Serv Res 8:218PubMedPubMedCentralCrossRef Carlsen B, Norheim OF (2008) ‘What lies beneath it all?’: an interview study of GP’s attitudes to the use of guidelines. BMC Health Serv Res 8:218PubMedPubMedCentralCrossRef
10.
Zurück zum Zitat Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR (1999) Why don’t physicians follow clinical practice guidelines? A framework for improvement. J Am Med Assoc 282(15):1458–1465CrossRef Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR (1999) Why don’t physicians follow clinical practice guidelines? A framework for improvement. J Am Med Assoc 282(15):1458–1465CrossRef
11.
Zurück zum Zitat Ellrodt AG, Conner L, Riedinger M, Weingarten S (1995) Measuring and improving physician compliance with clinical practice guidelines: a controlled interventional trial. Ann Intern Med 122:277–283PubMedCrossRef Ellrodt AG, Conner L, Riedinger M, Weingarten S (1995) Measuring and improving physician compliance with clinical practice guidelines: a controlled interventional trial. Ann Intern Med 122:277–283PubMedCrossRef
12.
Zurück zum Zitat Fox RD, Mazmanian PE, Putnam RW (1989) Changing and learning in the lives of physicians. Praeger Publications, New York, pp 161–175 Fox RD, Mazmanian PE, Putnam RW (1989) Changing and learning in the lives of physicians. Praeger Publications, New York, pp 161–175
13.
Zurück zum Zitat Dijkstra R, Wensing M, Thomas R et al (2006) The relationship between organizational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Serv Res 6:53PubMedPubMedCentralCrossRef Dijkstra R, Wensing M, Thomas R et al (2006) The relationship between organizational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Serv Res 6:53PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Davis DA, Taylor-Vaisey A (1997) Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ 157:408–416PubMedPubMedCentral Davis DA, Taylor-Vaisey A (1997) Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ 157:408–416PubMedPubMedCentral
15.
Zurück zum Zitat Grol R, Dalhuijsen J, Thomas S et al (1998) Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 317:858–861PubMedPubMedCentralCrossRef Grol R, Dalhuijsen J, Thomas S et al (1998) Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 317:858–861PubMedPubMedCentralCrossRef
16.
Zurück zum Zitat Human Development Report (2019) Beyond income, beyond averages, beyond today: inequalities in human development in the 21st century (PDF). HDRO (Human Development Report Office) United Nations Development Programme, pp 22–25. Retrieved 9 December 2019 Human Development Report (2019) Beyond income, beyond averages, beyond today: inequalities in human development in the 21st century (PDF). HDRO (Human Development Report Office) United Nations Development Programme, pp 22–25. Retrieved 9 December 2019
17.
Zurück zum Zitat Smith AB, Brooke BS (2019) How implementation science in surgery is done. JAMA Surg 154(10):891–892PubMedCrossRef Smith AB, Brooke BS (2019) How implementation science in surgery is done. JAMA Surg 154(10):891–892PubMedCrossRef
18.
Zurück zum Zitat Birrenbach T, Kraehenmann S, Perrig M, Berendonk C, Huwendiek S (2016) Physicians’ attitudes toward, use of, and perceived barriers to clinical guidelines: a survey among Swiss physicians. Adv Med Educ Pract 7:673PubMedPubMedCentralCrossRef Birrenbach T, Kraehenmann S, Perrig M, Berendonk C, Huwendiek S (2016) Physicians’ attitudes toward, use of, and perceived barriers to clinical guidelines: a survey among Swiss physicians. Adv Med Educ Pract 7:673PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Grol R, Dalhuijsen J, Thomas S, Rutten G, Mokkink H (1998) Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 317(7162):858–861PubMedPubMedCentralCrossRef Grol R, Dalhuijsen J, Thomas S, Rutten G, Mokkink H (1998) Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. BMJ 317(7162):858–861PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Syed SB, Dadwal V, Rutter P, Storr J, Hightower JD, Gooden R, Pittet D (2012) Developed-developing country partnerships: benefits to developed countries? Glob Health 8(1):17CrossRef Syed SB, Dadwal V, Rutter P, Storr J, Hightower JD, Gooden R, Pittet D (2012) Developed-developing country partnerships: benefits to developed countries? Glob Health 8(1):17CrossRef
21.
Zurück zum Zitat Niles SGM, Mitchell-Fearon K, Gill MI, DeSouza CJ, Fearon IC, Abel CA, McLennon NJ (2017) Mortality-related factors in gastroschisis—a Jamaican perspective. J Pediatr Surg 52(4):530–533CrossRef Niles SGM, Mitchell-Fearon K, Gill MI, DeSouza CJ, Fearon IC, Abel CA, McLennon NJ (2017) Mortality-related factors in gastroschisis—a Jamaican perspective. J Pediatr Surg 52(4):530–533CrossRef
22.
Zurück zum Zitat Bhattacharya S (2014) Was attending the conference worth value for money? Indian J Plastic Surg 47(1):1CrossRef Bhattacharya S (2014) Was attending the conference worth value for money? Indian J Plastic Surg 47(1):1CrossRef
23.
Zurück zum Zitat Christakis DA, Rivara FP (1998) Pediatricians’ awareness of and attitudes about four clinical practice guidelines. Pediatrics 101(5):825–830PubMedCrossRef Christakis DA, Rivara FP (1998) Pediatricians’ awareness of and attitudes about four clinical practice guidelines. Pediatrics 101(5):825–830PubMedCrossRef
24.
Zurück zum Zitat Jutras D (1993) Clinical practice guidelines as legal norms. CMAJ Can Med Assoc J 148(6):905 Jutras D (1993) Clinical practice guidelines as legal norms. CMAJ Can Med Assoc J 148(6):905
25.
Zurück zum Zitat Vermaas AM (2003) Liability in relation to the use of professional medical guidelines. Med L 22:233 Vermaas AM (2003) Liability in relation to the use of professional medical guidelines. Med L 22:233
Metadaten
Titel
Barriers to the implementation of new guidelines among pediatric surgeons: online survey
verfasst von
Abdulraouf Lamoshi
A. Gibbons
S. Williams
T. Ponsky
Publikationsdatum
25.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 9/2020
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-020-04707-y

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