Implementing Clinical Guidelines: A Resourse Pack for the Health Care Team

This workbook is a multi-disciplinary practical training manual which can be used by both groups and individuals to identify and implement clinical guidelines. The pack begins by introducing clinical guidelines and explaining the ways in which they differ from standards, criteria and other forms of defining practice. Next, the process by which uptake of guidelines in practice can be promoted and facilitated is outlined. The importance of prioritising and targeting service changes, in order to identify where and what improvements are needed to care, is stressed. Next, planning for change in line with evidence of best practice is discussed along with the preparation of professionals, patients and the environment, and how they can be enabled to make proposed changes a reality. Finally, the pack describes how the impact of change on the quality of care can be evaluated using rigorous methods of measurement. This final stage is of particular importance as the information generated is an important cornerstone for the framework of clinical governance. There are three ways to use the resource pack: for individual study, to work through with your clinical team, or to work through with a facilitator. The flexibility of the pack is brought about by the way it is organised into five modules as follows: Module 1 - choosing a clinical guideline to implement; Module 2 - using a small group to coordinate implementation of the clinical guideline; Module 3 - involving patients in the implementation of the clinical guideline; Module 4 - examining the context into which a clinical guideline will be introduced, devising a strategy for implementation and choosing techniques that can be used to encourage implementation of the guideline in practice; and Module 5 - the relationship between guidelines and clinical audit.

Table of Contents:
Introduction Introduction to the resource pack. The contribution of clinical guidelines to clinical effectiveness. What is evidence-based health care? What are clinical guidelines? Clinical guideline development. The relationship between clinical guidelines and clinically effective care. Steps to guideline implementation. References. Module 1: Choosing clinical guidelines Introduction. Preparing and developing a national clinical guideline for local implementation. Developing local guidelines if no national clinical guidelines exist. Summary. References. Further reading on appraising the quality of research. Appendix 1.1: Appraisal of NHS guidelines. Appendix 1.2: Appraisal instrument for clinical guidelines. Module 2: Facilitating a small group to coordinate guideline implementation Introduction. Why do we need groups to implement clinical guidelines? Understanding group dynamics. Facilitation helping groups work. Group techniques for problem-solving and decision-making. Summary. References. Further reading on facilitation. Module 3: Involving patients and carers in implementing clinical guidelines Introduction. Why should you involve patients in guideline implementation? Recruiting patient participants choosing who to involve. Ways of involving patients in guideline implementation. Patient involvement and evidence-based patient information. Barriers and levers to effective patient/carer involvement in guideline implementation. Summary. References. Module 4: Devising an implementation strategy Introduction. Reviewing current practice and the local environment. Preparing to implement a guideline. Identifying a range of techniques to promote implementation. Devising the implementation strategy. Evaluation. Doing it!. Learning from others. Summary. References. Further reading about implementing clinical guidelines in practice. Appendices: Appendix 4.1: Checklist for guideline dissemination. Appendix 4.2: Examples of patient information about clinical guidelines. Appendix 4.3: Summary of strategies for implementing clinical practice guidelines. Appendix 4.4: Dissemination/implementation strategies: summary. Appendix 4.5: Identifying techniques for implementing a clinical practice guideline. Appendix 4.6: Identifying techniques for implementinga clinical practice guideline. Appendix 4.7: Strategy for clinical guideline implementation. Appendix 4.8: Implementation strategy for implementing a clinical practice guideline. Appendix 4.9: Action plan of strategies for implementing a clinical practiceguideline. Module 5: Using clinical guidelines to evaluate care Introduction. Planning a clinical audit using clinical practice guidelines. Developing the clinical audit. Resources for clinical audit using guidelines. Summary. References. Appendix 5.1: Resources. Glossary.