title: Tailoring implementation strategies for evidence-based recommendations using computerised clinical decision support systems: protocol for the development of the GUIDES tools.
abstract: BACKGROUND
  A computerised clinical decision support system (CCDSS) is a technology that uses patient-specific data to provide relevant medical knowledge at the point of care. It is considered to be an important quality improvement intervention, and the implementation of CCDSS is growing substantially. However, the significant investments do not consistently result in value for money due to content, context, system and implementation issues. The Guideline Implementation with Decision Support (GUIDES) project aims to improve the impact of CCDSS through optimised implementation based on high-quality evidence-based recommendations. To achieve this, we will develop tools that address the factors that determine successful CCDSS implementation.
  
  
  METHODS
  We will develop the GUIDES tools in four steps, using the methods and results of the Tailored Implementation for Chronic Diseases (TICD) project as a starting point: (1) a review of research evidence and frameworks on the determinants of implementing recommendations using CCDSS; (2) a synthesis of a comprehensive framework for the identified determinants; (3) the development of tools for use of the framework and (4) pilot testing the utility of the tools through the development of a tailored CCDSS intervention in Norway, Belgium and Finland. We selected the conservative management of knee osteoarthritis as a prototype condition for the pilot. During the process, the authors will collaborate with an international expert group to provide input and feedback on the tools.
  
  
  CONCLUSIONS
  This project will provide guidance and tools on methods of identifying implementation determinants and selecting strategies to implement evidence-based recommendations through CCDSS. We will make the GUIDES tools available to CCDSS developers, implementers, researchers, funders, clinicians, managers, educators, and policymakers internationally. The tools and recommendations will be generic, which makes them scalable to a large spectrum of conditions. Ultimately, the better implementation of CCDSS may lead to better-informed decisions and improved care and patient outcomes for a wide range of conditions.
  
  
  BACKGROUND
  PROSPERO, CRD42016033738.
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway. Stijn.vandevelde@fhi.no.
authors.forename: Stijn
authors.initials: S
authors.lastname: Van de Velde
authors.affiliation: McMaster University, Hamilton, Canada.
authors.forename: Pavel
authors.initials: P
authors.lastname: Roshanov
authors.affiliation: Tampere University Hospital, Tampere, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Kortteisto
authors.affiliation: Duodecim, Scientific Society of Finnish Physicians, Helsinki, Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Kunnamo
authors.affiliation: Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Aertgeerts
authors.affiliation: MAGIC Non-Profit Research and Innovation Programme, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Per Olav
authors.initials: PO
authors.lastname: Vandvik
authors.affiliation: Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Signe
authors.initials: S
authors.lastname: Flottorp
mesh_terms: D001530:Belgium; D002908:Chronic Disease; D002985:Clinical Protocols; D020000:Decision Support Systems, Clinical; D019317:Evidence-Based Medicine; D005387:Finland; D006801:Humans; D009664:Norway; D020370:Osteoarthritis, Knee / Q000628:therapy; D010865:Pilot Projects; D058996:Quality Improvement