Clinical effectiveness: the potential for change in maternity care

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Abstract
Aim: To assess the potential for improved clinical effectiveness through the use of research‐based evidence in obstetric care. Design: A questionnaire survey to obtain evidence about (i) the usage of reviews of controlled perinatal trials, and (ii) the attitudes of professionals towards the reviews and their practice, relating to 27 areas of clinical care addressed by the reviews. Subjects and setting: All doctors and midwives working in two teaching hospital maternity units (Units X and Y). Main outcome measures: The use of the reviews. For each of the 27 areas of clinical care, (i) whether a majority of professionals were in agreement with research‐based evidence, and (ii) how perceived current practice compared with research‐based evidence. Results: For most areas of clinical care (21/27 in unit X, 20/27 in unit Y) a majority of professionals agreed with the research‐based evidence. However, for a large proportion of these areas (16/21 in unit X, 12/20 in unit Y), practice appeared to be inconsistent with research‐based evidence. Conclusion: There is a considerable opportunity to improve clinical effectiveness, as in many of the areas of care examined professionals agree with research‐based evidence, but clinical practice appears to be inconsistent. The approach used in this study could be used to help develop practices for promoting clinical effectiveness.