Many health authorities and most trusts have no written strategy for improving clinical effectiveness and cannot claim to take the issue seriously. More than half the health authorities and more than a third of trusts responding to the survey had some clinical effectiveness initiative underway. Most of these concerned a single topic. Access to clinical information needs to be improved. Many hospital libraries restrict access and are not open outside office hours.
Performance indicators sould take effectiveness into account.
The authors also proposed a checklist of questions that could be used in any organisation to ensure that all areas of possible action were being covered. A number of different approaches are being adopted to promote evidence-based healthcare and the faster and more systematic adoption of research findings. Northern and Yorkshire region has commissioned projects to support the implementation of evidence-based healthcare. It focused primarily on health authorities, giving highest priority to ownership of the programme by the whole organisation, as opposed to one directorate, and to the integration of this activity in the whole range of the health authority s work. The NHS Executive in England has produced a performance development framework for assessing the work that is being done to promote clinical effectiveness.