Implementing clinical guidelines: preparation and opportunism

Clinical guidelines are likely to be key components of any Health Service Trust's framework for improving clinical effectiveness. Initial results from the seven pilot sites of the NHS consensus strategy for major clinical guidelines have suggested a number of factors that can contribute to their successful implementation. They include a managed and structured process; adequate preparation; open and collaborative dialogue between appropriate stakeholders; clear identification of local clinical and managerial priorities; a receptive corporate environment; and health care professionals motivated to improve practice. Finally, in the turbulent setting of contemporary health care, the ‘luck’ of a successful implementation is often ‘preparation meeting opportunity’.