The role of clinical opinion leaders in guideline implementation and quality improvement

Background: The lag between the publication of clinical and health-services research and the application of this information is substantial and delays health-care improvement. A wide range of corrective strategies are being u sed to address this issue. Objectives: Evolution in the use of significant opinion leaders is describe d. Hospital quality improvement projects, undertaken by the Healthcare Educ ation and Research Foundation (HERF), are used to illustrate the roles assu med by clinical opinion leaders. Specific theoretical frameworks are review ed that are fundamental to successful implementation of opinion leader stra tegies, as well as key research on the use of clinical opinion leaders. Results: Over the past 12 years, HERF has identified the need to address no t only the information needs of clinicians and organizations but also the s ocial and organizational factors that interfere with the application of res earch and guidelines, The complexity of this task cannot be underestimated. However, armed with well-developed guidelines and the opportunity to work within structured guideline implementation programs with well-defined objec tives and systematically applied methods, HERF's experience suggest local c linicians and communities can meet this challenge.