Editorials

Is clinical effectiveness a management issue?

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7127.243 (Published 24 January 1998) Cite this as: BMJ 1998;316:243

Yes, doctors and managers need each other to implement evidence based practice

  1. Michael Dunning, Programme managera,
  2. Myriam Lugon, Medical directorb,
  3. John MacDonald, Chief executivec
  1. a PACE programme, King's Fund, London W1AM 0AN
  2. b Forest Healthcare NHS Trust, PO Box 13, Woodford Green, Essex IG8 8DB
  3. c Oxford Radcliffe Hospital NHS Trust, Oxford OX3 9DU

    Action on clinical effectiveness is showing that success in implementing evidence based practice is achieved only when there are real local partnerships between clinicians and managers. The challenge is not to turn clinicians into managers but to recognise that some aspects of the task are the direct responsibility of managers. The recent white paper on the NHS, with its emphasis on quality and concept of clinical governance,1 has given added impetus to the creation of these partnerships. The requirement for chief executives of trusts to make “appropriate local arrangements” may make little progress unless doctors and managers reach a shared understanding of their distinct contributions to the development of evidence based practice and generate enthusiasm for the approach in organisations.

    Progress may be contentious because some clinicians are sceptical about the interest of managers in clinical effectiveness and evidence based practice.2 Clinicians are usually interested—and excited—by discussions about research, but their interest wanes when those discussions progress to questions about the routine use of research findings. Interest in implementation is often viewed …

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