Soft Systems Methodology for Implementing Clinical Practice Guidelines in A General Hospital: A study protocol

Background: It is notoriously challenging to implement evidence-based care and to update and improve health care policy. Adhering to evidence-based Clinical Practice Guidelines (CPGs) serves as the driving force behind making decisions based on the best evidence and making efforts for improving the quality of patient care and outcomes. Despite requiring Iranian hospitals to implement CPGs in January 2017, the concept and implementation method of CPGs remained to be clarified. This action research focuses on acquiring an in-depth understanding of how to define and implement CPGs in a selected general hospital in Iran. Methods: Given the inherent roles of technical processes, organizational culture, and personnel perspectives in providing clinical care, implementing CPGs was considered a complex problem situation. Therefore, we will employ Soft Systems Methodology (SSM) to conceptualize the situation. We will conduct semi-structured in-depth interviews and hold group discussions with different stakeholders to define purposeful activity models. Moreover, we will use SSM tools and techniques to identify the main areas of changes, and select necessary measures to facilitate the implementation of CPGs. Flexible qualitative methods of data collection and analysis are utilized throughout the study. Results: Applying SSM in implementing CPGs can generate knowledge through recognizing a hyper-complex situation, adopting an attitude of inquiry, and promoting dynamic changes in diverse worldviews of professionals in the accommodation process. The knowledge can provide a model for successful policy implementation in other public health issues. Conclusion: This article can foster the application of systems approaches, and especially SSM, in addressing complex issues in healthcare settings.