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Several reviews have focussed on the effectiveness of different interventions for implementing guidelines and improving care [ 5, 6, 8- 12].
Local antibiotic guidelines and an antibiotic team are scored as the two currently most important interventions for implementing ASP in both types of hospitals.
In adapting the model, we will use evidence of effective interventions for implementing SDM in clinical practice [ 36] and refer to the barriers and facilitators identified in phase 1 to make a toolkit of interventions that enhance SDM and promote changes to clinical practices.
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Future research could involve a cost-benefit analysis of the intervention for implementing such initiative.
We question the wisdom of streaming referrals from primary care without a strong evidence base and an effective intervention for implementing guidelines.
We found that FPs' exposure to DECISION +, a multifaceted intervention for implementing SDM in medical practices that included training, reminders and feedback, was associated with a decrease in decisions for "immediate antibiotics" compared to decisions for "delayed/no antibiotics" (49% vs. 33% absolute difference = 16%; p = 0.08 and relative risk = 0.69; 95% CI: 0.47-1.03).
Findings from the EWAPS study come in line with relevant literature, entailing significant implications for the necessity to apply a more effective and efficient paradigm in the design and delivery of educational interventions, advocating for implementing learner-centered schemata in CME and benefiting from a model that draws on the learning environment and social aspects of learning.
Stakeholders may be the potential recipients of the intervention, or responsible for implementing it, including patients, health care providers, managers and policy-makers.
The findings of this study have important policy implications for health programme design and intervention planning: These findings suggest that age is an important factor to consider for implementing interventions to address child morbidity in Ghana.
It is also helpful in the identification of key partners for implementing interventions based on these frameworks.
There is conflicting evidence from the literature as to whether single or multifaceted interventions are more effective for implementing guidelines.
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