Table 3

Questions to Address Before Disseminating Organization-Wide Practice Standards

Problem clarificationWhat problem are we trying to solve with our standard?How important is it to address this issue?
What are the root causes of this problem?
Are the problems localized or generalized?
What is the evidence that the proposed standard is effective?
CollaborationHave we included front-line clinicians in the development of the standard?Has there been sufficient input from each clinical unit that will be impacted by the standard?
How are the various units working to improve this issue—what innovative ideas do they have?
What do individual sites or teams see as potentially beneficial improvements?
Has the standard been pilot tested with input from those impacted?
Is there agreement that a system-wide set of standards is needed?
How will we encourage local customization and evaluate its impact?
ConsequencesHave we considered unintended consequences?What are the potential harms to patients, teams and the organization from implementing the standards?
ResourcesDo we have sufficient resources to design, implement, and evaluate the impact of the standard?How difficult will it be to gather the evidence to design the standard?
Does the organization have the capacity to implement it?
Do we have valid metrics for subjective as well as objective outcomes?
Does the organization have the capacity to evaluate the full range of benefits and harms of implementing the standard?