Improving Patient Care: The Implementation of Change in Clinical Practice

In the field of health care, a very large number of valuable insights, procedures and technologies become available each year. These come from well planned scientific research or careful experiments and evaluation in everyday practice. As many of these innovations are not adopted into daily practice, at the expense of improved patient care, it is crucial to understand how sucessful implementation can be achieved.

There are many reasons for this failure, such as the nature of the proposed method of working or simply that it is new; similarly, economic, structural or financial barriers may exist. Given the increasing significance and frequency of change in healthcare environments, the new research findings and hence insights into the implementation of change must be made available. This is the purpose of the book.

Aids the implementation of various changes including: the adoption of clinical guidelines; new procedures, technologies, care programmes and preventative programmes; care protocols, care pathways or processes that may lead to an improvement in patient care ['best practices']; removal of undesirable routines and variations in the care provided.
All recommendations are based upon scientific evidence, careful evaluation or on good experience in practice - thus, on innovations that are firmly established as being able to contribute to better care for patients.
Evidenced-based approach meets the need to learn from available evidence.
Practical examples support readers who learn through experiences.
Gives particular emphasis to implementation of clinical guidelines, one of the most important aids to achieving optimal care for patients.
Demonstrates how any future implementation of clinical guidelines is an important part of their generation.
Explains the importance of target group involvement in initial planning and delivery.
Outlines helpful and unhelpful factors in the success of implementation of change and describes cost-effective strategies for overcoming them.
Describes the role of firm organisation in planning and systems for evaluation.
Takes the perspective of the implementer although includes discussion of the impact of change through the eyes of the target group.
Translates principles and models to practice by providing action plans.
Generalizable approach widens the book to all sectors of healthcare management.

Richard Grol; Michel Wensing; and Martin Eccles, William Leech Professor of Primary Care Research, Professor of Clinical Effectiveness (Personal Chair), Centre for Health Services Research, University of Newcastle upon Tyne, Newcastle upon Tyne, UK