The primary goal of our survey was to compare the availability of each resource to implement the SSC guidelines, the percentage of implementable guidelines, and the possibility to implement the SSC guidelines (Grade 1 and 2 recommendations) and their associated sepsis bundles (resuscitation and management bundles) between respondents and hospitals from African and high-income countries.
The interquartile range of implementable guidelines (57.5 to 87.7%) was wide, suggesting considerable heterogeneity among respondents.
We found that no guideline development instructional manuals offered advice on how to generate implementable guidelines [ 35].
By aiding the design and operationalization of highly implementable guidelines, our goal is that application of GLIA may help improve health outcomes.
While this is true, the approach of creating implementable guidelines, thought to be most promising by guideline developers and which we are investigating, is meant to help users overcome those contextual barriers.
By aiding the design and operationalization of highly implementable guidelines, our goal is that application of GLIA may help to improve health outcomes, but further evaluation will be required to support this potential benefit.
The percentage of implementable SSC guidelines was different between African respondents working in hospital of different types (<0.01 for all comparisons; data not shown).
Likewise, guideline implementers may use GLIA to select implementable recommendations and to devise implementation strategies that address identified barriers.
See related research by Baelani et al., http://ccforum.com/content/15/1/R10 In their article in this issue of Critical Care, Baelani and colleagues [ 1] attempt to determine whether or not Surviving Sepsis Campaign (SSC) guidelines are implementable in African low- and middle-income countries (LMICs), where hospitals often lack the resources necessary for managing critically ill patients.
Thus, GLIA can be used to help select guidelines that are more easily implementable and also to devise implementation strategies that address identified barriers.
