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Research and Clinical Effectiveness
Factsheet 2
 

GUIDELINES FOR SETTING UP A CLINICAL EFFECTIVENESS GROUP

Locally based clinical effectiveness groups can prove an excellent forum for discussing research relevant to your practice. They have a number of benefits:

Personal:

  • Stimulate critical thinking

  • Personal/Professional development

  • Help develop skills in critical examination of recent research evidence relevant to your practice

Professional:

  • Support the development of evidence-based practice

  • Support staff development through the dissemination of robust research outcomes

  • Promote awareness of research in the clinical setting

  • Support the provision of optimal care for the patient

  • Provide an opportunity for all clinical staff to influence the service planning process

  • Promote professional communication

  • Group working is efficient, several heads are better than one

Research has shown that successful groups have the following characteristics (Sidorov 1995, Sandifer 1996, Bandolier 1997):

Support from management

The participants have undergone critical appraisal skills training

Lunch time meetings

Refreshments provided

How to set up a group

  • Within the professional group identify interested staff, these could include managers 8-10 is a maximum size group for useful discussion

  • Arrange departmental critical appraisal training for these staff

  • Formation of clinical effectiveness groups

  • Groups to decide the format of their meetings, i.e. frequency, venue, content

  • Identify a link to the senior management group (he/she could sit on the group)

  • Elect a Chair/Facilitator (Rotate regularly)

  • Decide terms of reference for the group

  • Consider how you will evaluate the group

A successful plan for meetings would be (Sackett 1997, Bandolier 1977):

Meeting 1

  • Decide the format of meetings i.e. frequency, venue, content.

  • Identify a link to your management group.

  • Decide the terms of reference for the group.

  • Consider how you will evaluate the group.

  • Determine a key clinical/professional problem. Points to consider are cost, frequency and priority.

  • Express it in the form of a specific question with a patient or problem, an intervention, a setting and an intended outcome

  • Search for evidence of solutions, in particular systematic reviews - the medical library may be able to support or provide this search.

Meeting 2

  • One member decides which research is relevant and orders the papers.

  • Papers discussed and the those felt to be most relevant given to group members to critically appraise.

Meeting 3

The chosen papers and results of the critical appraisal are discussed. Further discussion of whether the evidence has real relevance for practice should then take place. Brief details of the outcomes are recorded and kept with the papers. They should also be circulated to professional colleagues as relevant.

Meeting 4

If appropriate management is made aware of any recommendations from the group in a brief paper (one or two sheets). Discussion can then take place regarding possible implementation of the findings. In this way business planning could benefit from the activities of the groups. Priorities identified by management could also be fed to the groups to investigate and research.

Groups might also consider professionally relevant systematic reviews. Furthermore the group could be used for discussion of local research requirements, research training needs etc.

The group’s format will evolve with its membership. Whilst these guidelines are designed to support the formation of clinical effectiveness groups, each group will develop an identity of its own.

References

  • Bandolier (1997) No. 43 p.7

  • McMahon Ann Journal Clubs. Nursing Standard Vol 12 No.13-15 p.40-41, 1997

  • Sackett D et al (1997) Evidence-based medicine: how to practice and teach EBM Churchill Livingstone

  • Sandifer Q, Lo S, Crompton P. (1996) ‘Evaluation of a journal club as a forum to practise critical appraisal skills’ J of the Royal College of Physicians of London 30 (6): 520-2

  • Sidorov J (1995) ‘How are internal medicine residency journal clubs organised, and what makes them successful?’ Archives of Internal Medicine 155(11) 1193-7

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