Improving Clinical Quality and Reducing Clinical Variation

It is well recognised that best practice guidance is not delivered for 30-40% of patients that can benefit from the guidance, also 20-25% of patients get care that is not needed or potentially harmful[1]. This has implications for both patient outcomes and health care costs.

Furthermore, attempts to promote best practice are rarely evidence based leading to recurring wasted efforts and resources and failure to sustain best practice.

Over the last decade, implementation science has sought to bring academic rigour to clinical quality improvement and ensure that it is as evidence based as the guidance it seeks to promote. Implementation science recognises that clinical behaviour is determined by factors at the level of the individual, service or organisation and offers new theories, tools and frameworks which can guide analysis of the barriers to implementation as well as the evidence to plan and deliver implementation strategies.

The CfBCP provided leadership around the implementation agenda, assessing need, raising awareness of the complexities of evidence based implementation and promoting access to experts, theories and tools which can promote successful implementation.

baseline needs assessment undertaken in 2014 revealed challenges around measurement, leadership and organisational structures in primary care.  Evaluation revealed that many stakeholders have a poor understanding of implementation science, are unlikely to use systematic approaches to either analyse the implementation challenge or select the most appropriate tools.

The CfBCP Masterclass programme addressed these issues on a regional level, ensuring that stakeholders have access to regional, national and international experts to support the development of a regional pool of expertise. Stakeholders who attended the Masterclasses in person or via the online resources have been able to develop skills and knowledge in various aspects of implementation science to support them in addressing implementation challenges within their organisations, with tools and frameworks to support analysis and strategy development.

Feedback from delegates who attended the Master Classes has confirmed the benefits they have realised, both in terms of increased knowledge and skills relating to implementation science and they are well placed to support the AHSN’s commitment to deliver on its remit to improve clinical quality and reduce clinical variation within their organisations.

[1] Schuster, McGlynn, Brook (1998) Millbank Memorial Quarterly Grol R (2001). Med Care