The preparation of implementation aids such as desk-top guides and the patient information materials is an idea that could easily be „borrowed‟ from this study for
Use elsewhere. The same is true of the format of the team meetings and the training materials used. The questionnaire used to assess the health care providers‟ intention of beginning to use the guidelines can also be lend. Instead of the large sample needed for scientific research purposes, in daily practise small samples of about ten medical records can be used as input for the plan-do-check-act cycle to monitor progress in implementing the guidelines. One limitation of the study is the use of before-and-after design to evaluate the effect of our implementation activities. Without the use of a control group and proper randomization procedures, we cannot conclude definitively that the changes in behaviour that we observed resulted from the efforts aimed at implementing the guideline.