Guidelines in the United kingdom and how they are used.
The main sources of guidelines in kidney disease in the United Kingdom are the National Institute of Health and Clinical Excellence (NICE), the UK Renal Association, and the Scottish Intercollegiate Guideline Network (SIGN). These groups now all adopt similar methods of guideline development, but implementation methods differ and also vary in their effectiveness. The structure of UK health care lends itself to an integrated implementation strategy, and the United Kingdom is almost unique in being able to introduce simultaneously related changes that aid implementation nationally, thereby enabling implementation locally. Use of these strategies is variable with possibly too much reliance on existing systems that deliver predictable suboptimal results and a failure to embed implementation strategies into routine organizational structure. The next steps for us in the United Kingdom are to use service improvement methods to improve and sustain consistently implementation of evidence-based practice.
Stevens
Paul E
PE
Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury CT1 3NG, UK. paul.stevens@ekht.nhs.uk
Tomson
Charles R V
CR
D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine; D033161:Government Regulation; D019983:Guideline Adherence / Q000331:legislation & jurisprudence; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D017146:Models, Organizational; D009313:National Health Programs / Q000331:legislation & jurisprudence / Q000458:organization & administration; D010043:Outcome and Process Assessment, Health Care / Q000331:legislation & jurisprudence; D011050:Policy Making; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D017582:Renal Replacement Therapy; D016896:Treatment Outcome; D006113:United Kingdom