Dr Patricia Donald, Guideline Coordinator, Royal College of General Practitioners, Edinburgh

1. Keep it simple

  • Plan small steps at a time, setting achievable goals.
  • Remember this is about patient care, not 'doing audit' or 'doing guidelines'.
  • Teamwork is essential. This requires motivation and enthusiasm, but working and learning together can be a rewarding experience.

2. How do you identify areas of patient care that could be improved?

  • What are the practice, local and national priorities?

3. Where are you now?

  • A local audit package may be able to help you, or you could design your own simple assessment of current practice.

4. Where do you want to be?

  • Are there suitable guidelines to help?
  • What are the key recommendations you aim to adopt?
  • Don't try to implement the whole set of guidelines – pick out the most important recommendations and use these as your target.

5. How will you get there?

  • Changing clinical practice takes planning and teamwork.
  • Take your time and think things through. Consider how you will record information, recruit patients, and provide educational support for both the team and your patients.
  • Who will be responsible for implementation, and what is a realistic time-scale?

6. How will you know how well you are doing and how will you continue to provide this quality of care?

  • Audit will help but this requires continuous monitoring, not just a 'dip-stick' approach. Feedback is important and helps to encourage everyone to keep going.

The RCGP in Scotland is actively involved in developing tools to help practices implement the national guidelines produced by Scottish Intercollegiate Guidelines Network (SIGN). These tools include the production of primary care summaries of the key recommendations from the guidelines, and educational packages to support specific guidelines.

For more information please contact:

  • Dr Patricia Donald RCGP Guideline Coordinator
  • Anne Farquharson RCGP Guideline Facilitator

    Post: Royal College of Physicians, 9 Queen Street, Edinburgh EH2 1JQ
    Tel: 0131 225 7324
    Email: a.farquharson@rcpe.ac.uk

Guidelines in Practice, November 1998, Volume 1
© 1998 MGP Ltd
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