title: A multifaceted knowledge translation strategy can increase compliance with guideline recommendations for mechanical bowel preparation.
abstract: The successful transfer of evidence into clinical practice is a slow and haphazard process. We report the outcome of a 5-year knowledge translation (KT) strategy to increase adherence with a clinical practice guideline (CPG) for mechanical bowel preparation (MBP) for elective colorectal surgery patients. A locally tailored CPG recommending MBP practices was developed. Data on MBP practices were collected at six University of Toronto hospitals before CPG implementation as well as after two separate KT strategies. KT strategy #1 included development of the CPG, education by opinion leaders, reminder cards, and presentations of data. KT strategy #2 included selection of hospital champions, development of communities of practice, education, reminder cards, electronic updates, pre-printed standardized orders, and audit and feedback. A total of 744 patients (400 males, 344 females, mean age 57.0) were included. Compliance increased from 58.6 to 70.4% after KT strategy #1 and to 81.1% after KT strategy #2 (p < 0.001). Using a tailored KT strategy, increased compliance was observed with CPG recommendations over time suggesting that a longitudinal KT strategy is required to increase and sustain compliance with recommendations. Furthermore, different strategies may be required at different times (i.e., educational sessions initially and reminders and standardized orders to maintain adherence).
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: Cagla
authors.initials: C
authors.lastname: Eskicioglu
authors.forename: Emily
authors.initials: E
authors.lastname: Pearsall
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Aarts
authors.forename: Allan
authors.initials: A
authors.lastname: Okrainec
authors.forename: Robin S
authors.initials: RS
authors.lastname: McLeod
mesh_terms: D013505:Digestive System Surgical Procedures / Q000592:standards*; D017558:Elective Surgical Procedures / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000379:methods*; D057170:Translational Research, Biomedical / Q000592:standards*