Understanding the relation between research and clinical policy: a study of clinicians' views.

Berrow, D; Humphrey, Christopher; Hayward, John A.

doi:10.1136/qshc.6.4.181

Cited by 18 publications

(16 citation statements)

References 6 publications

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“…However, sophisticated medicine is an art. (Johnson, 2002(Johnson, : 1495 Studies not surprisingly therefore indicate that adoption of guidelines depends very much on local practice, as well as individual disposition (Berrow et al, 1997;Dye et al, 2000;Foy et al, 2001;Templeton et al, 2001). Clinical Governance and Clinical Audit seems likely to be important here in putting them on the agenda in many organisational situations.…”

Section: Operational Governancementioning

confidence: 94%

Analysing policy processes as multiple governance: accountability in social policy

Hill

Hupe

2006

Policy &Amp; Politics

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EnglishThere is a need to develop appropriate ways to analyse issues about complexity in the governance process and about accountability. The preoccupation with policy 'stages' need to be replaced with a more complex model of the way in which policy decisions are inter-related or 'nested'. It is argued that a 'multiple governance framework', influenced by Elinor Ostrom's 'institutional analysis and development' framework, offers a way to do this. The framework is illustrated using examples from English health and education policy, where there are opposed positions about professional autonomy and about local prerogatives, to show how this approach assists the analysis of issues like these. FrançaisIl est nécessaire de mettre au point des moyens convenables pour analyser les problèmes complexes du processus de gouvernance et de responsabilité. L'obsession pour les « stades » en politique doit faire place à un modèle plus complexe montrant la façon dont les décisions sont étroitement liées ou s'emboîtent. On invoque qu'un « cadre multiple de gouvernance », influencé par la structure d'Elinor Ostrom « analyse et développements institutionnels » offre un moyen d'atteindre ce but. La structure est illustrée à l'aide d'exemples tirés de la politique de santé et d'éducation en Angleterre, où on remarque des positions opposées sur l'autonomie professionnelle et les prérogatives locales, afin de démontrer comment cette approche facilite l'analyse de tels problèmes. EspañolExiste una necesidad en el desarrollo de las formas apropiadas para analizar temas acerca de la complejidad en el proceso de la forma de gobierno y acerca de la responsabilidad. La preocupación con las "etapas" políticas se necesitan reemplazar con un modelo más complejo de la manera en la que las decisiones políticas están interrelacionadas o "nested". Se argumenta que un marco de forma de gobierno múltiple, influenciado por el marco de "análisis institucional y de desarrollo" de Elinor Ostrom, ofrece una manera para hacer esto. El marco es ilustrado usando ejemplos del sistema de salud inglés y la política de educación, donde existen posiciones opuestas acerca de la autonomía profesional y acerca de las prerrogativas locales, para mostrar cómo este acercamiento asiste al análisis de temas como estos.

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Section: Operational Governancementioning

confidence: 94%

Analysing policy processes as multiple governance: accountability in social policy

Hill

Hupe

2006

Policy &Amp; Politics

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“…Rather, it was their awareness of the limitations of research data which made them sceptical. Concerns were expressed about the doubtful validity and uneven quality of some research studies and about the adequacy or relevance of their findings for clinical practice ( Berrow et al . 1997 ).…”

Section: Resultsmentioning

confidence: 99%

“…Ideas and information about barriers to implementation have accrued from a variety of different sources including: theoretical literature on the uptake of innovations within and beyond health care ( Rogers 1983; Williams & Gibson 1990); analyses of the impact of different implementation strategies ( Grimshaw & Russell 1993); studies in which clinicians in various fields were asked what they thought would prevent them applying evidence ( Grol 1992; Mansfield 1995; Dawson 1995; Walsh 1997); and detailed case studies of specific initiatives for changing clinical practice ( Dopson et al . 1994 ; Berrow et al . 1997 ; Wood et al .…”

Section: Introductionmentioning

confidence: 99%

In the eye of the beholder: problems of perception in designing a strategy to promote evidence‐based clinical policy

Humphrey¹,

Berrow

2000

Evaluation Clinical Practice

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Independent qualitative evaluation of a project designed to ensure that clinical policy in specific areas of care in three obstetric units within one English health district was based on authoritative evidence. Data from nonparticipant observation, interviews, questionnaires and documents were combined to generate a description of what the project involved and analyses from the perspectives of two key groups of stakeholders: the project proponents and the unit staff whose policies the project was intended to address. Key aspects of the project are examined from these perspectives to elucidate the assumptions of those involved in the project design and assess the adequacy of their attempts to facilitate success. Attempts were made to meet many of the accepted criteria for effective implementation. Nevertheless, the majority of unit staff retained significant doubts about the validity of the project's starting point and the approach adopted. The project process was followed as anticipated. After one year the intended work programme had been completed. The proponents saw the project as quite successful; they were unaware of the extent of the reservations still held by unit staff. The proponents focused on potential barriers that 'made sense' in the light of their own values and priorities. Failure to recognize the actual causes of concern was due to not hearing or listening to unit staff. Intended strengths of the project design were viewed quite differently by staff because they did not share the proponents' basic premises. Approaches to promoting evidence-based practice which take account of the views of all parties regarding problems and solutions are more likely to succeed.

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“…Berrow et al reported that divergence of clinical practice from research evidence is often due to concerns about the adequacy and applicability of the research and concerns about the ability of the medical community to enact changes based on evidence. 18 Further investigation into what factors are important for the incorporation of evidence on PSA screening into clinical practice would be illuminating, particularly when the outcomes of clinical trials differ.…”

Section: Discussionmentioning

confidence: 99%

Erratum: PSA screening: determinants of primary-care physician practice patterns

Tasian¹,

Cooperberg²,

Potter³

et al. 2012

Prostate Cancer Prostatic Dis

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Understanding the relation between research and clinical policy: a study of clinicians' views.

Abstract: Objectives-To describe the relation between research evidence and local obstetric unit policy for specific areas of care and to explore clinicians' views about the reasons for any discrepancies identified.

Cited by 18 publications

References 6 publications

Analysing policy processes as multiple governance: accountability in social policy

Analysing policy processes as multiple governance: accountability in social policy

In the eye of the beholder: problems of perception in designing a strategy to promote evidence‐based clinical policy

Erratum: PSA screening: determinants of primary-care physician practice patterns

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