Barriers to clinical guidelines: the need for concerted action

Aims to provide a framework for identifying barriers to the implementation of a clinical guideline by examining a clinical effectiveness programme and a review of relevant literature. A total of 41 types of barrier were identified and categorised according to characteristics of the guideline to be introduced, the individuals who need to change behaviour and the organisation or environment in which the change is to occur. Several groups have the potential to overcome such barriers, ranging from individual clinicians to national policy makers. Multi‐level as well as multi‐faceted strategies may be required to overcome barriers to the effective implementation of clinical guidelines.