Cover -- Title Page -- Copyright -- Contents -- List of Contributors -- Foreword -- Preface -- Acknowledgements -- Chapter 1 Introduction -- Introduction -- What is the role of evidence? -- How can guidance be used to track improvement? -- What are the challenges to achieving quality improvement? -- How does NICE support implementation? -- Raising awareness -- Motivating change -- Practical support -- Monitoring impact -- Summary overview -- Learning from practice -- References -- Further reading -- Example in Practice: Using clinical leaders to improve patient care -- NICE guidance highlights room for improvement -- Audit reveals areas where care can be improved -- Increased compliance with NICE guidance -- Learning from practice -- Chapter 2 Practical actions for health care providers -- Introduction -- Why take a systematic approach to guidance implementation in a health care provider organisation? -- Legal and regulatory context -- Cost pressures and quality improvement -- Public and patient involvement -- Staff training and continuing professional development -- What defines quality improvement for health care providers? -- What practical advice do health care providers require? -- Why board support and clear leadership for achieving high-quality care is important? -- Who should be the day-to-day lead for quality? -- Do you have an effective multidisciplinary forum for strategic decision-making on the use of best practice guidance? -- Why a lead for each new development should be nominated? -- Why take a systematic approach to financial planning for service change? -- Developing an action plan -- Evaluate uptake, provide high-level assurance and share your success story -- Summary -- Learning from practice -- References -- Further reading -- Example in Practice: A hospital-wide approach to reduce mortality among acutely ill patients.

Promptly escalating care for deteriorating patients -- How did the hospital carry out the project? -- Improving rates for mortality and cardiac arrest -- Learning from practice -- Chapter 3 Identifying a high-quality evidence base -- Introduction -- Why it is important to seek high-quality evidence -- How does guidance support evidence-based medicine? -- How can the standard of guidance development be checked? -- How does guidance perform against these standards? -- Can the ability of guidance to improve patient outcomes be checked? -- How can high-quality evidence be found? -- What is NICE accreditation? -- What does NICE accreditation say about guidance quality? -- What if there is no relevant high-quality guidance? -- How to get high-quality evidence into practice? -- Learning from practice -- References -- Further reading -- Example in Practice: Finding a way through guidance on pre-hospital care across South West England -- Finding a way through guidance -- Smart access on the move -- Monitoring improvement in outcomes -- Learning from practice -- Chapter 4 Key challenges to implementation and effective interventions -- Introduction -- What are the main factors that will influence an implementation project? -- What are the context and resource issues to consider? -- What have others done? -- Is there a recognised need for change? -- How to engage and influence? -- How to move forward? -- How to assess current barriers and facilitators? -- How to find out more about behaviours and barriers? -- How to prioritise action? -- What interventions should be used in the implementation plan? -- How to design the implementation project and evaluation? -- Summary overview -- Learning from practice -- References -- Further reading -- Example in Practice: Changing behaviour in primary care to improve the management of children with feverish illness.

Four key components not being measured -- Provide prompts to change current practice following education -- Measuring improvement -- Chapter 5 Using financial systems to support improved care -- Introduction -- Why is good financial management important? -- Can financial systems and levers help drive improvements in the provision of health care? -- How is quality incentivised in the English NHS? -- What is the QOF? -- What are PbR and BPT? -- What is CQUIN? -- How can funding arrangements incorporate NICE and other evidence-based guidance? -- What are the components of a good business case? -- Why should finance be considered across a health economy? -- Summary -- Learning from practice -- References -- Further reading -- Example in Practice: Building a business case: to redesign diabetes services -- Remodelling services for type 2 diabetes -- Using savings from implementing NICE guidance to redesign services -- Multidisciplinary team brought several improvements -- Learning from practice -- Chapter 6 Using measurement to support change and improvements in health care -- Introduction -- How can measurement be used to support change? -- Developing measures and indicators: lessons from the national experience -- Developing measures and indicators: issues for local consideration -- What is the best way to report and communicate data? -- Involving the team -- Reporting to the board -- Engaging patients through reporting of data -- Formats for reporting to each audience -- How to provide leadership for change? -- Acknowledging the structure and context of service provision -- Identifying the individual or groups to provide feedback -- Summary overview -- Learning from practice -- References -- Further reading -- Example in Practice: Setting up a service for peripheral arterial disease in the North West of England.

Using NICE guidance to redesign services -- Benefits of managing PAD in the community -- Learning from practice -- Chapter 7 Conclusion and reflections -- Introduction -- Why we think high-quality evidence should be sought? -- Review of the chapters in this book -- What constitutes clinical quality and what is quality improvement? -- How does guidance support evidence-based medicine? -- What are the barriers to the use of guidance? -- Reflections on service improvement -- How is clinical quality defined and how is it measured? -- Clinical audit -- How is a clinical audit performed? -- Whose responsibility is the achievement of high-quality care? -- Summary overview -- Learning from practice -- References -- Further reading -- Index -- EULA.