Cited by 233Clinical practice guidelines implementationHealth Policy Implementation ScienceHealth Sciences Research and Education

Evidence-Based Strategies for Implementing Guidelines in Obstetrics: A Systematic Review

Chaillet, Nils, Dubé, Eric, Dugas, Marylène, Audibert, François, Tourigny, Caroline, Fraser, William D., Dumont, Alexandre·2006·Obstetrics & Gynecology

Abstract

OBJECTIVE: To estimate effective strategies for implementing clinical practice guidelines in obstetric care and to identify specific barriers to behavior change and facilitators in obstetrics. DATA SOURCES: The Cochrane Library, EMBASE, and MEDLINE were consulted from January 1990 to June 2005. Additional studies were identified by screening reference lists from identified studies and experts' suggestions. METHODS OF STUDY SELECTION: Studies of clinical practice guidelines implementation strategies in obstetric care and reviews of such studies were selected. Randomized controlled trials, controlled before-after studies, and interrupted time series studies were evaluated according to Effective Practice and Organization of Care criteria standards. TABULATION, INTEGRATION, AND RESULTS: Studies were reviewed by two investigators to assess the quality and the efficacy of each strategy. Discordances between the two reviewers were resolved by consensus. In obstetrics, educational strategies with medical providers are generally ineffective; educational strategies with paramedical providers, opinion leaders, qualitative improvement, and academic detailing have mixed effects; audit and feedback, reminders, and multifaceted strategies are generally effective. These findings differ from data on the efficacy of clinical practice guidelines implementation strategies in other medical specialties. Specific barriers to behavior change in obstetrics and methods to overcome these barriers could explain these differences. The proportion of effective strategies is significantly higher among the interventions that include a prospective identification of barriers to change compared with standardized interventions. CONCLUSION: Prospective identification of efficient strategies and barriers to change is necessary to achieve a better adaptation of intervention and to improve clinical practice guidelines implementation. In the field of obstetric care, multifaceted strategy based on audit and feedback and facilitated by local opinion leaders is recommended to effectively change behaviors.

Integrity signals

Registry

Crossref · 10.1097/01.aog.0000236434.74160.8b

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Reviews in specific clinical fields discussed the possibility that tailored strategies might be more effective than strategies selected without taking account of determinants, but did not address the effect or costs of tailored interventions specifically.

    “Although there are a number of reviews in specific clinical fields (Chaillet 2006; Kroenke 2000), which have discussed the possibility that tailored strategies might be more effective than strategies selected without taking account of determinants, these reviews did not address the effect or costs of tailored interventions specifically.”

    From Tailored interventions to address determinants of practice (2015) · cites this paper as Chaillet 2006

Cites

Flagged first, then by citations

1 of the 60 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Chaillet, N., Dubé, E., Dugas, M., Audibert, F., Tourigny, C., Fraser, W. D., & Dumont, A.
Affiliations
Centre Hospitalier Universitaire Sainte-Justine (CA)
Venue
Obstetrics & Gynecology
Published
2006-11
Volume
108
Issue
5
Pages
1234-1245
ISSN
0029-7844 (ISSN-L)
OpenAlex
W2021456087
Cited by
233
References
60
Citations by year
2026: 7 · 2025: 7 · 2024: 2 · 2023: 5 · 2022: 15 · 2021: 6 · 2020: 11 · 2019: 11 · 2018: 14 · 2017: 14 · 2016: 14 · 2015: 23 · 2014: 16 · 2013: 16 · 2012: 14
FWCI
1.47
Type
journal article
Language
en
Open access
closed
Locations
  • Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
guideline implementation, obstetric care, barriers to behavior change, audit and feedback, opinion leaders, academic detailing, multicomponent intervention, educational intervention, reminders, health care provider behavior
MeSH terms
Diffusion of Innovation, Humans, Obstetrics, Professional Practice, Quality of Health Care, Practice Guidelines as Topic, Evidence-Based Medicine, Guideline Adherence, Information Dissemination

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review