Review

The PACE of change

EXPERIENCE, EVIDENCE AND EVERYDAY PRACTICE: creating systems for delivering effective health care
M Dunning, G Abi-Aad, D Gilbert, H Hutton, C Brown
Kings Fund, 1999, £12.95

This record of the work of PACE (Promoting Action on Clinical Effectiveness) over three years, involving 16 separate projects throughout England, is surprisingly readable. Its clear format and structure allows easy access to some interesting and detailed data on the overall programme topic of ‘understanding how to implement change in clinical practice’.

Refreshingly this study does not take as a basic assumption the premise that change per se is automatically good or necessary. Nor do the authors assume that change is upon us and we should simply make the best of it. Considerable space is given to examining the realities of living and working within a changing professional framework, and an attempt is made to deal with the real costs, in both financial and human terms.

The authors’ approach is positive but never blinkered: problems encountered by the project groups are discussed and analysed as objectively as possible and effective ways forward are also critically examined.

Many professionals are now accustomed to working within a framework of constant change and it is easy (especially whenever new ‘buzz’ words appear) to become extremely worried about what we are really looking at or agreeing to. This study should help anyone currently in a state of private panic by demonstrating beautifully that any situation can be assessed, plans can be made that follow on from the data produced and that implementation can be made a practical reality. This will make it a worthwhile read for many health professionals.