The POISE study
What is the best approach to implementing guidelines?
POISE is an acronym for the peri-operative fasting guideline implementation study evaluation project. The Royal College of Nursing in collaboration with the Royal College of Anaesthetists are conducting a national research study evaluating guideline implementation strategies. Eighteen trusts across the four countries of the UK are participating in the study.
Grimshaw et al (2004) suggest that getting evidence into practice remains a challenge. Whilst there is evidence to suggest that education strategies, feedback on performance, mass media campaigns and facilitative approaches might have some effect on guideline implementation, further evaluation of these interventions is required.
Three guideline implementation strategies are being compared:
- standard dissemination (SD) alone
- SD with an opinion leader and web based educational resource
- SD with the Plan Do Study Act quality improvement model.
The study will evaluate which implementation strategy is more effective and will identify local barriers and facilitators to guideline implementation. Trusts will be randomised to one of the three implementation strategies.
Fasting times are being collected from patients in each trust four times before an implementation period and four times after (time series design). Patients and staff will be interviewed to gain their opinion on fasting practice within the NHS and on barrier and facilitators to changing practice.
Reference
Grimshaw JM, Thomas RE, MacLennan G, et al. (2004) Effectiveness and efficiency of guideline dissemination and implementation strategies Health Technology Assessment 8(6).