Changing clinician practice remains a challenge. Production of up-to-date evidence-based clinical guidelines without targeted implementation strategies does not ensure evidence uptake. There is evidence of failure to translate research findings into clinical practice: 30-40% of patients do not get treatments of proven effectiveness; 20-25% of patients receive care that is not needed or potentially harmful (Schuster et al. 1998); with only 55% of patients receiving recommended care (McGlynn et al. 2003). A 2010 Cochrane review concluded that ‘Interventions tailored to prospectively identified barriers are more likely to improve professional practice than no intervention or dissemination of guidelines’ (Baker et al. 2010. p.2).
The Fever, Sugar and Swallowing (FeSS) Intervention
The QASC trial used an evidence-based implementation strategy based on behaviour change principles to foster teamwork and collaboration amongst multidisciplinary clinicians to implement clinical protocols for the management of fever, hyperglycaemia and swallowing difficulties. We then rigorously evaluated the effect of this intervention on patient outcomes using a cluster randomised control design. More information can be found on the FeSS Intervention details page.