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Health professionals tell us how to help them do well

Last year we surveyed health professionals on their views on the Stroke Foundation’s efforts in knowledge translation, i.e. how well we support turning evidence-based clinical guidelines into improved practice. We found enthusiasm for both InformMe and for living guidelines, but requests for more email communications and training to help people keep up with new recommendations.

The survey was held from 31 October to 17 December 2018, and 385 people responded. Two thirds (66%) said they were users of InformMe, and they were pretty positive about the website.

A standard measure of customer satisfaction is the Net Promoter Score (NPS), calculated from responses to the question, “How likely is it that you would recommend InformMe to a friend or colleague?” Per cent negatives are subtracted from per cent positives, to give a score between +/- 100.

Net Promoter Score of 49, with 12% detractors, 61% promoters, and 27% passive

What makes a good NPS is literally a million-dollar question, but the Wikipedia entry says that “a NPS of +50 is generally deemed excellent.” That InformMe is rated very nearly excellent is a remarkable success.

A similarly positive picture emerges when asked about specific sections of InformMe:

Graph of user ratings of the usefulness of InformMe features

The guidelines are the most appreciated component, followed by learning modules, new research and audit data. We still have room to improve, especially in areas like My Feed, so more detailed feedback and usability tests will be used to make improvements.

InformMe is not the only game in town though, which is why we also asked people to nominate their go-to destinations for information to improve stroke care.

Graph of user responses to the question of where they currently get information to improve stroke care

Stroke Foundation channels featured highly, but professional and clinical networks had the greatest number of responses, and nearly as many professionals turned to journals for stroke care information.

But even though many people went elsewhere for their information, InformMe was still considered the most effective method for sharing the stroke guidelines, preferred by 29% of respondents. It was closely followed by email alerts, at 26% of responses.

More email alerts was also the most common suggestion when people were asked how we can improve our communication of guidelines. As a result, you can expect to receive more frequent emails from us.

Beyond communication though, we also asked what else helps with guideline implementation. Here, 35% of people nominated some form of training, while 30% said audits.

Nearly a third of respondents also suggested more training when asked how we can better support them to follow the guidelines, although many also requested practical implementation tools.

We also asked what were the main barriers to using the guidelines, and the results weren’t surprising:

Word cloud of the biggest challenges people face in using the stroke guidelines, with Time being the main one

Many people face the challenge of a lack of time, resources and funding to meet the demands of the clinical guidelines. Although this is expected, it shows the importance of us working with health professionals to make it as easy to learn and implement the guidelines as possible.

A promising sign is the response to our question about the living guidelines project, and whether it would make people more likely to follow them.

Graph of users' view on how making the guidelines living will affect how likely they are to use them

Eighty per cent saying that having living guidelines would make them more likely to use them. And as expected, the reason for their enthusiasm was that they’d know guidelines would be more current:

  • “This is an excellent idea, everybody wants to rely on good quality and up to date information.”
  • “I would have much more trust in the guidelines if they were regularly updated with new research.”
  • “I use them a lot already but I am keen for them to be continually updated rather than waiting for a roll out date.”

By using the findings from this survey to improve InformMe, and how we communicate clinical guidelines and support their adoption, we hope that we can realise the promise that people expect from living guidelines.