Table 3 Distribution of Adaptation Choice by Section across 10 Institutions (N = 1350 Statements*)

n (%)

n (%)

n (%)

N

570

60

720

Adaptation Choice

 Adopt

301 (52.8)

29 (48.3)

221 (30.7)

 Adapt

177 (31.1)

30 (50.0)

450 (62.5)

 Reject

47 (8.2)

1 (1.7)

38 (5.3)

 Because of previous decision, statement no longer applicable

45 (7.9)

0 (0.0)

11 (1.5)

Adaptations

n = 177

n = 30

n = 450

 Resource(s) added

14 (7.9)

6 (20.0)

76 (16.9)

 Resource(s) partially removed (some retained)

15 (8.5)

0 (0.0)

119 (26.4)

 Resource(s) all removed (none retained)

1 (0.6)

0 (0.0)

13 (2.9)

 Added statement to follow institutional standard or order set

10 (5.6)

6 (20.0)

16 (3.6)

 Removed statement to follow institutional standard

1 (0.6)

1 (3.3)

11 (2.4)

 Articulated action be based on severity of bothersome symptom

19 (10.7)

11 (36.7)

186 (41.3)

 Changed conditional (“consider x”) to strong (“do x”) statement

44 (24.9)

1 (3.3)

101 (22.4)

 Changed content of statement or combined two or more statements

97 (54.8)

12 (40.0)

152 (33.8)

 Medication(s) removed

14 (7.9)

0 (0.0)

51 (11.3)

 Medication(s) added

16 (9.0)

0 (0.0)

32 (7.1)

 Medication substituted with a related medication

0 (0.0)

0 (0.0)

50 (11.1)

 Statement moved to another section (e.g. prevention to treatment)

2 (1.1)

1 (3.3)

8 (1.8)

 Removed or modified hyperlink

13 (7.3)

0 (0.0)

8 (1.8)

Rejections

n = 47

n = 1

n = 38

 Statement not relevant for primary team

3 (6.4)

1 (100.0)

4 (10.5)

 Did not agree with statement

42 (89.4)

0 (0.0)

28 (73.7)

 Personnel unable to offer intervention due to lack of availability

2 (4.3)

0 (0.0)

6 (15.8)