Is it possible to make ‘living’ guidelines? An evaluation of the Australian Living Stroke Guidelines
Journal article
Wiles, Louise, Hibbert, Peter, Zurynski, Yvonne, Smith, Carolynn L., Arnolda, Gaston, Ellis, Louise A., Lake, Rebecca, Easpaig, Brona Nic Giolla, Molloy, Charlotte, Middleton, Sandra Jane, Braithwaite, Jeffrey, Hill, Kelvin and Turner, Tari. (2024). Is it possible to make ‘living’ guidelines? An evaluation of the Australian Living Stroke Guidelines. BMC Health Services Research. 24(1), pp. 1-10. https://doi.org/10.1186/s12913-024-10795-6
Authors | Wiles, Louise, Hibbert, Peter, Zurynski, Yvonne, Smith, Carolynn L., Arnolda, Gaston, Ellis, Louise A., Lake, Rebecca, Easpaig, Brona Nic Giolla, Molloy, Charlotte, Middleton, Sandra Jane, Braithwaite, Jeffrey, Hill, Kelvin and Turner, Tari |
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Abstract | Background: Keeping best practice guidelines up-to-date with rapidly emerging research evidence is challenging. ‘Living guidelines’ approaches enable continual incorporation of new research, assisting healthcare professionals to apply the latest evidence to their clinical practice. However, information about how living guidelines are developed, maintained and applied is limited. The Stroke Foundation in Australia was one of the first organisations to apply living guideline development methods for their Living Stroke Guidelines (LSGs), presenting a unique opportunity to evaluate the process and impact of this novel approach. Methods: A mixed-methods study was conducted to understand the experience of LSGs developers and end-users. We used thematic analysis of one-on-one semi-structured interview and online survey data to determine the feasibility, acceptability, and facilitators and barriers of the LSGs. Website analytics data were also reviewed to understand usage. Results: Overall, the living guidelines approach was both feasible and acceptable to developers and users. Facilitators to use included collaboration with multidisciplinary clinicians and stroke survivors or carers. Increased workload for developers, workload unpredictability, and limited information sharing, and interoperability of technological platforms were identified as barriers. Users indicated increased trust in the LSGs (69%), likelihood of following the LSGs (66%), and frequency of access (58%), compared with previous static versions. Web analytics data showed individual access by 16,517 users in 2016 rising to 53,154 users in 2020, a threefold increase. There was also a fourfold increase in unique LSG pageviews from 2016 to 2020. Conclusions: This study, the first evaluation of living guidelines, demonstrates that this approach to stroke guideline development is feasible and acceptable, that these approaches may add value to developers and users, and may increase guideline use. Future evaluations should be embedded along with guideline implementation to capture data prospectively. |
Keywords | Living guidelines; Clinical guidelines; Guideline adherence; Evidence based healthcare management |
Year | 01 Jan 2024 |
Journal | BMC Health Services Research |
Journal citation | 24 (1), pp. 1-10 |
Publisher | BMC (BioMed Central) Springer |
ISSN | 1472-6963 |
Digital Object Identifier (DOI) | https://doi.org/10.1186/s12913-024-10795-6 |
Web address (URL) | https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-10795-6 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1-10 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 03 Apr 2024 |
Publication process dates | |
Accepted | 28 Feb 2024 |
Deposited | 26 Aug 2024 |
Additional information | © The Author(s) 2024. |
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/90x08/is-it-possible-to-make-living-guidelines-an-evaluation-of-the-australian-living-stroke-guidelines
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OA_Middleton_2024_Is_it_possible_to_make_living.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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