Table 4.

Modifiable and non-modifiable targets of intervention to narrow the knowledge-to-action gap

Category	Feature	Target of future interventions
Patients related factor	Non modifiable factor	Early and appropriate diagnosis Timely surgical approach
Environmental factor	Modifiable factor	Complex patients centralization in emergency general surgery service
		Hub and spoke networks for emergency general surgery
		Introduction of structured emergency general surgery verification programs
		Creation of institutional program for guidelines implementation with dedicated clinical bundles for knowledge translation from CPG and daily clinical practice critical appraisal
		Dedicated national and local dynamic programs to identify barriers to knowledge implementation
Surgeon-related factor	Modifiable and non-modifiable factor	Surgeons psychological empowerment to improve the ability to deal with adverse event and standardize the mental approach during emergency cases
		Encourage periodical update sessions on evidence-based practices
		Dedicated educational intervention on evidence-based medicine to improve the ability to understand CPG recommendations (basic statistics, methodology, consensus and guidelines building process)

We categorized barriers to evidence-based surgery and reported possible approaches to implement the knowledge-to-action transition