How useful is an online tool to facilitate guideline implementation? Feasibility study of using eGLIA by stroke clinicians in Australia

Background: The success of guidelines is determined by their use in the real world. The GuideLine Implementability Appraisal (GLIA) tool was developed as a quality-improvement tool to assist guideline developers and guideline users identify potential problems in implementing recommendations. The objective of this study was to assess the feasibility of using the electronic version of GLIA (eGLIA) by implementers of a clinical guideline for acute stroke management in Australia. Methods: Health professionals who had no previous experience with the eGLIA tool but who are involved in implementing guidelines volunteered for the study. These health professionals were provided background information about the tool and were provided a short training session (< 30 min). The participants were asked to consider at least two recommendations from the guideline document. Time spent, numbers of recommendations reviewed and subjective feedback of the process were used for evaluation. Results: 40 participants completed the study, representing nursing and allied health professions from different geographical regions of Australia. The median number of recommendations per participant completed was 2 (range 2-10), taking an average of 47 min (range 15-120 min) to complete or about 22 min per recommendation. Ninety-four per cent of participants agreed or strongly agreed that eGLIA was useful, while 77% indicated they would use the tool again. eGLIA helped participants think systematically about implementation, although only 72% agreed that the tool allowed them to clearly identify potential barriers to implementation. Conclusion: This study suggests that eGLIA may be a useful tool which is relatively easy to use for implementers of guidelines. eGLIA enables a detailed, systematic evaluation of guidelines. Further refinement of the tool is recommended to better assist implementers to clearly identify barriers to implementation and therefore facilitate greater implementation. Further work is also warranted to determine the effect of using eGLIA as part of an implementation strategy and if it improves health outcomes.