What’s the purpose of this guide?
This guide offers practical, evidence-based advice on how to implement evidence-based care in general practice.
Clinical research continually produces new evidence that can improve patient and population outcomes. Yet such evidence does not reliably find its way into everyday patient care. There are well-documented variations in the delivery of evidence-based care which cannot be easily explained away by differences in patient populations (e.g. deprivation levels).
NICE guidance promotes treatments of proven benefit and discourages treatments of less value to patients and health services. However, as you already know, getting evidence into practice is generally easier said than done within the everyday constraints and challenges of general practice.
What’s our rationale?
Like it or not, a lot of good quality research shows that most interventions to change clinical practice have modest effects. However, repeated small changes can make a big difference. We can make a significant contribution to improving population healthcare and health by:
· general practices combining efforts
· focusing their attention on ‘high impact’ clinical priorities
· underpinned by a sound evidence based
· associated with scope for improvement
It is entirely feasible to achieve major impacts by using existing quality improvement resources effectively and through targeted, cumulative improvements.
Who is this guide for?
This guide is mainly for people leading improvement across small to large groups of general practices. However, some content may be flexible enough to inform both national initiatives and improvements within single general practices.
How can you use this guide?
The first, and only, rule of this guide is that there are no rules on how to use it. If you are planning a big improvement across lots of general practices and have sufficient time and resources, you could use this as a step-by-step guide. However, realistically, you will be working within a tight time frame and with limited support. So, you might prefer to jump straight to making a change. This could involve, for example, adapting some of our illustrative audit and feedback resources.
We don’t claim that this is a comprehensive guide. Where possible, we have included links to supporting online resources.
Who developed this guide?
This guide is based upon a major research programme, Action to Support Practices Implementing Research Evidence (ASPIRE). The research was led by the University of Leeds and brought together collaborators including the West Yorkshire clinical commissioning groups, patients and the public, and representatives from the National Institute for Health and Care Excellence (NICE). Over 200 general practices from West Yorkshire took part in the research programme.
This study was funded by the National Institute for Health Research (NIHR) [Programme Grants for Applied Research (Grant Reference Number RP-PG-1209-10040)]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.