How do doctors keep up to date with guidelines?

Background

Clinical guidelines continually evolve, and doctors are expected to stay up to date with their recommendations in order to provide the best care to their patients. However, it isn’t always clear exactly how doctors stay informed about new and updated clinical guidelines, or whether this is happening effectively.

New guidelines are published frequently by a variety of organisations, and there is no widespread systematic way of keeping clinicians informed in real time. This topic is not well-explored in existing literature, and the studies that do exist do not provide enough robust evidence to recommend any particular strategy for keeping doctors up to date.

Individual doctors have a responsibility to keep themselves up to date, but organisations that employ doctors and/or produce guidelines also share some responsibility for ensuring that doctors are up to date. It is not entirely clear how this shared responsibility should work in practice.

Without a reliable, systematic process, there is a risk that important guidance may not reach front-line clinicians in a timely or usable way, potentially compromising patient care, consistency of practice, and equity in healthcare delivery.

We aim to investigate the current landscape of guideline dissemination and develop a robust, ethically grounded national strategy to improve how general medical doctors are kept up to date with new and revised clinical guidelines.

Approach

Our work is structured around three key research questions:

1. How do doctors working in general internal medicine in UK hospitals become aware of newly published or updated guidelines?
2. How might the process of keeping doctors up to date with new guidelines be improved?
3. Whose responsibility is it to ensure that doctors are up to date?

The project involves four steps:

1. We will carry out interviews with doctors who use guidelines and people who circulate guidelines to doctors, followed by a national survey of doctors, to understand how the process of doctors finding out about new guidelines works currently.
2. We will design clinical vignettes (concise, focused patient case studies) using recently published guideline recommendations, and test doctors’ awareness and understanding of them. This will help us to identify whether doctors are managing to stay up to date successfully.
3. We will carry out ethical analysis by putting together insights from the literature, our survey of doctors, the vignette study, and interviews with doctors and people who circulate guidelines, and using these to examine issues such as who is responsible for making doctors aware of new and changed guidelines, the potential burdens on clinicians, and the issues around equal access to guideline information.
4. We will hold an interpretive forum with participants from earlier stages to collaboratively review and interpret findings from the data collection and ethical analysis. We will begin to plan further research aiming to develop and evaluate potential strategies to improve this issue on a national level.

Project team

Dr Clare Leong

THIS Institute

Dr Zoë Fritz

THIS Institute

Professor Graham Martin

THIS Institute