Implementation plan

Recommendation	Time needed for implementation: < 1 year, 1 tot 3 years or > 3 years	Anticipated effect on costs	Conditions for implementation within designated time frame)	Possible barriers for implementation1	Actions needed for implementation2	Who is responsible for actions3	Other comments
Using a transcervical balloon catheter for IOL seems safe with regard to cord prolapse	< 1 year	none
Using amniotomy for IOL in combination with other methods facilitating head engagement seems safe with regard to cord prolapse after consideration of other risk factors	< 1 year	none

¹ Barriers may exist at the level of the professional, of the organisation (hospital) or of the system (outside the hospital). For instance, disagreement with regard to the recommendation, insufficient motivation of knowledge of the specialist, insufficient facilities or personnel, need for concentration of care, costs, lack of collaboration between disciplines, necessary rearrangement of tasks, et cetera.

² These can be actions necessary for implementation, but also actions that can facilitate implementation. For instance, checking recommendations during quality visitation, publication of the guideline, development of implementation tools, informing hospital directors, warranting adequate remuneration for a particular treatment, arranging collaboration agreements.

³ Who is responsible for implementation of the recommendations also depends on the level of the barriers. Barriers at the level of the professional often need to be solved by the professional society. Barriers at the level of the organisation often are the responsibility of hospital directors. For solving barriers at the level of the system other parties, such as umbrella organisations for care and health insurance are needed.