Achieving clinical effectiveness: just another initiative or a real change in working practice?

The move to develop evidence‐based health care requires an integrated approach to using information in clinical practice. This paper discusses the issues involved in accessing appropriate information and enabling clinical staff to use this information at three levels; firstly in solving immediate clinical problems, secondly in developing clinical guidelines and finally in making resource allocation decisions. The need to use educational processes and change management to achieve improved clinical care based upon evidence is also discussed as well as how this change can be evaluated through clinical audit and outcome measurement.