Examining the implementation of NICE guidance: cross-sectional survey of the use of NICE interventional procedures guidance by NHS Trusts

Implementation Science

John Powell²  Bruce Campbell²  Louise Carr¹  Alexandra Filby¹  Michelle Jenks¹  Karin Lowson¹ 

[1] York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington YO10 5NQ, York, UK;National Institute for Health and Care Excellence, 10 Spring Gardens, London SW1A 2BU, UK

关键词: Organisational behaviour;    Dissemination;    Evidence-based practice;    Implementation;    Guideline;   

Others  :  1219012
DOI  :  10.1186/s13012-015-0283-4

 received in 2015-02-23, accepted in 2015-06-22,  发布年份 2015

【 摘 要 】

Background

In the UK, NHS hospitals receive large amounts of evidence-based recommendations for care delivery from the National Institute for Health and Care Excellence (NICE) and other organisations. Little is known about how NHS organisations implement such guidance and best practice for doing so. This study was therefore designed to examine the dissemination, decision-making, and monitoring processes for NICE interventional procedures (IP) guidance and to investigate the barriers and enablers to the implementation of such guidance.

Methods

A cross-sectional survey questionnaire was developed and distributed to individuals responsible for managing the processes around NICE guidance in all 181 acute NHS hospitals in England, Scotland, Wales and Northern Ireland. A review of acute NHS hospital policies for implementing NICE guidance was also undertaken using information available in the public domain and from organisations’ websites.

Results

The response rate to the survey was 75 % with 135 completed surveys received. Additionally, policies from 25 % of acute NHS hospitals were identified and analysed. NHS acute hospitals typically had detailed processes in place to implement NICE guidance, although organisations recognised barriers to implementation including organisational process barriers, clinical engagement and poor targeting with a large number of guidance issued. Examples of enablers to, and good practice for, implementation of guidance were found, most notably the value of shared learning experiences between NHS hospitals. Implications for NICE were also identified. These included making improvements to the layout of guidance, signposting on the website and making better use of their shared learning platform.

Conclusions

Most organisations have robust processes in place to deal with implementing guidance. However, resource limitations and the scope of guidance received by organisations create barriers relating to organisational processes, clinician engagement and financing of new procedures. Guidance implementation can be facilitated through encouragement of shared learning by organisations such as NICE and open knowledge transfer between organisations.

【 授权许可】

   
2015 Lowson et al.

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