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  1. T Smith,
  2. G Harvey,
  3. F Campbell

    https://doi.org/10.1136/qhc.0100187..

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      Getting evidence based health care into practice

      An implementation gap between evidence and practice seems to be a characteristic of all health systems. Strategies to close this gap are complex, time consuming, and may not always make much difference. Early results of educational programmes may be encouraging, but sustainability, long term change, and continued better care for patients must be the ultimate goals.

      Eisenberg JM. What does evidence mean? Can the law and medicine be reconciled?

      J Health Politics, Policy and Law 2001;26:369–81.

      Popular attention has focused of late on the role of evidence in health care. Physicians have been encouraged to practice evidence-based medicine so that their clinical decisions would be based upon a foundation of solid science, especially using research that has applied rigorous epidemiologic methods and has been published in peer-reviewed journals. Every participant in the healthcare system should care about how evidence is defined. Patients will receive services based upon how evidence is weighed, and clinicians will provide services based upon their conclusions about the evidence of effectiveness and risk. Healthcare managers, purchasers, and system leaders will make decisions based upon the evidence that certain services should be provided to the clientele that they serve, and policy makers, including judicial policy makers such as judges and juries, will weigh evidence to decide whether harm has been done because a service was or was not provided.

      Ayanian JZ, Quinn TJ. Quality of care for coronary heart disease in two countries.

      Health Aff 2001;20:55–67.

      Abstract reproduced from original.

      Coronary heart disease is the leading cause of death in the US and England, and each country devotes substantial resources to its prevention and treatment. Recent strategies for improving quality of care for coronary heart disease in each country are reviewed, including clinical guidelines; national standards; performance reports; benchmarking, feedback, and professional leadership; and market-oriented approaches. These strategies highlight the importance of information systems, organizational culture, and incentives to improve the quality of care in both the decentralized health care system of the US and England's more centralized system.

      Richardson J. Post-operative epidural analgesia: introducing evidence-based guidelines through an education and assessment process.

      J Clin Nurs 2001;10: 238–45.

      The aim of this project …

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