Implementing guidelines in general practice care.

Classic approaches to implementing new information fail because firstly too little attention is given to the specific barriers to change in certain groups of doctors and practices. Also too much effort is spent on improving knowledge and attitudes and too little on improving skills and actual behaviour; too little is known about interventions and programmes that are really effective in changing GPs’ performance. In this paper I shall explore the current views and research on implementing guidelines and suggest some recommendations on methods and approaches to quality improvement in general practice. I shall discuss in more detail some of the general principles of promoting change in clinical care highlighted by Stocking in this journal. (excerpt)