title: Refining a taxonomy for guideline implementation: results of an exercise in abstract classification.
abstract: BACKGROUND
  To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strategies.
  
  
  METHODS
  A draft implementation taxonomy was developed based on the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. The draft taxonomy had four domains (professional, financial, organisational and regulatory) covering 49 distinct strategies. We piloted the draft taxonomy by using it to classify the implementation strategies described in the conference abstracts of the implementation stream of the 2010 Guideline International Network Conference. Five authors classified the strategies in each abstract individually. Final categorisation was then carried out in a face-to-face consensus meeting involving three authors.
  
  
  RESULTS
  The implementation strategies described in 71 conference abstracts were classified. Approximately 15.5% of abstracts utilised strategies that could not be categorised using the draft taxonomy. Of those strategies that could be categorised, the majority were professionally focused (57%). A total of 41% of projects used only one implementation strategy, with 29% using two and 31% three or more. The three most commonly used strategies were changes in quality assurance, quality improvement and/or performance measurement systems, changes in information and communication technology, and distribution of guideline materials (via hard-copy, audio-visual and/or electronic means).
  
  
  CONCLUSIONS
  Further refinement of the draft taxonomy is required to provide hierarchical dimensions and granularity, particularly in the areas of patient-focused interventions, those concerned with audit and feedback and quality improvement, and electronic forms of implementation, including electronic decision support.
authors.affiliation: Department of General Practice, School of Primary Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Ferntree Gully Rd, Notting Hill, Victoria, Australia. Danielle.Mazza@monash.edu
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
authors.forename: Phillip
authors.initials: P
authors.lastname: Bairstow
authors.forename: Heather
authors.initials: H
authors.lastname: Buchan
authors.forename: Samantha Paubrey
authors.initials: SP
authors.lastname: Chakraborty
authors.forename: Oliver
authors.initials: O
authors.lastname: Van Hecke
authors.forename: Cathy
authors.initials: C
authors.lastname: Grech
authors.forename: Ilkka
authors.initials: I
authors.lastname: Kunnamo
mesh_terms: D057189:Checklist; D002965:Classification; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D019983:Guideline Adherence; D010865:Pilot Projects; D017410:Practice Guidelines as Topic