Determinants of successful guideline implementation: a national cross-sectional survey

Abstract Background CPGs are not uniformly successful in improving care and several instances of implementation failure have been reported. Performing a comprehensive assessment the barriers enablers is key to developing an informed strategy. Our objective was investigate determinants guideline explore associations self-reported adherence guidelines with characteristics participants China. Methods This cross-sectional survey, using multi-stage stratified typical sampling based on China's economic regional divisions (the East, Middle, West Northeast). 2–5 provinces were selected from each region. 2–3 cities province, secondary tertiary hospitals city included. We developed questionnaire underpinned by recommended methods for design conduct self-administered surveys conceptual framework use, in-depth related literature analysis, development manuals, behavior change theory. Finally, multivariate analyses performed logistic regression produce adjusted odds ratios (OR) 95% confidence intervals (95% CI). Results The consisted four sections: knowledge methodology guidelines; accessing guideline; implementation; implementation. There 1732 (87.3% response rate) 51 hospitals. Of these, 77.2% reported used frequently or very frequently. use lack education training (46.2%), overly simplistic wording broad scope recommendations (43.8%). Level associated geographical regions northeast P < 0.001; west = 0.02; middle 0.001 compared east), hospital grades ( 0.028), length practitioners’ practice 0.006), background (Ph.D., 0.027; Master, 0.002), evidence-based medicine skills acquired work unit 0.012), medical specialty practitioner (General Practice, 0.006; Surgery, 0.043). Conclusion Despite general acknowledgement importance guidelines, as frequent might expected. To optimize likelihood should follow actively dissemination plan incorporating features our study.