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Table 3 Summary of phased implementation strategy derived from the BCW/COM-B framework

From: Development of a theory-driven implementation strategy for cancer management guidelines in sub-Saharan Africa

Summary of phased implementation strategy
Phase 1: Guideline launch
 • Guideline distribution: hard and soft copies (via AgileMD, Inc. smartphone application)
 • Publicity campaign for guideline implementation effort “brand” with announcements, flyers
 • Awareness raising of regional and international efforts to implement context-specific guidelines
Phase 2: National Summit for Guideline Training
 • Dedicated teaching about benefits of guideline-based practice and regional efforts (knowledge)
 • Dedicated teaching of guideline content including evidence basis for guidelines (knowledge)
 • Dedicated training in guideline-based practice (skills)
 • Dedicated training in DST form completion (skills)
 • Dedicated workshop focusing on monitoring and evaluation of implementation strategy, including outcome measurement
 • Separate dedicated training for Champions
Phase 3: Ongoing reinforcement of guideline-based practice
 • Champions will:
   Model guideline-concordant practice on an ongoing basis on rounds and during institutional conferences
   Routinely discuss guidelines (or supporting evidence basis) basis during rounds and conferences and encourage other providers to do so, including residents and nurses
   Provide academic recognition for actions to promote guideline-concordant care
 • Documentation: DST form completion, inclusion of rationale for treatment decisions in clinical documentation
 • Team-based rounds to include consultant, resident, and nurse
 • Assignment of one consultant per patient
 • Integrate guidelines into regular training curriculum
 • Establish forum of Implementation Leaders, Champions, and any interested providers to evaluate implementation on an ongoing basis and refine as needed
 • Establish “safe space” to discuss protocol deviations and errors, including root cause analysis