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Challenge of introducing evidence based medicine into clinical practice: An example of local initiatives in paediatrics

Michael Ogundele (Alder Hey Royal Children's Foundation Hospital NHS Trust, Liverpool, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 9 August 2011




This article aims to review the available literature on how clinicians meet the daily challenge of translating medical information into clinical EBM. It also seeks to describe the procedures involved in a local initiative in the UK to develop software applications for implementation of national clinical guidelines to enhance EBM in routine clinical practice.


It was hypothesised that improved access to these guidelines in routine clinical practice could be achieved through integrated local procedures, thereby enhancing the quality of care provided to children and adolescents with asthma or UTI. A literature search was performed using databases. To explore the preferences of the doctors and other healthcare professionals on how they accessed clinical guidelines, feedback was obtained. Stepwise implementation of the clinical guidelines was instituted over a period of three years in different primary care and hospital settings.


The professionals actively engaged with all the different stages in the implementation of the clinical guidelines. The majority preferred the interactive computerized system based on its ease of use, better aesthetic features, familiarity with the software and limited dependence on the technical skills of the users.

Research limitations/implications

The limitations of this study include lack of systematic data to assess the clinical effectiveness of the guidelines' implementation. Another apparent limitation of the study is the small size of participants within the paediatric unit of each organisation where the study was conducted.

Practical implications

There is a need for further comparative studies between the local intervention strategies described in this study and other implementation strategies, to identify the most effective implementation methods for electronic guideline‐based systems.

Social implications

Reliable high quality guidelines from reputable professional bodies could be successfully implemented at the primary or hospital‐based levels through a series of coordinated multidisciplinary interactive processes. This study has positive implications for improving the quality of care provided to children and adolescents, enhancing the role of clinical governance, provision of useful information to patients/carers and other healthcare providers.


This study highlights a potentially effective way of implementing and integrating an electronic guideline‐based computer system into local practice.



Ogundele, M. (2011), "Challenge of introducing evidence based medicine into clinical practice: An example of local initiatives in paediatrics", Clinical Governance: An International Journal, Vol. 16 No. 3, pp. 231-249.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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