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Logo of bmjThis ArticleThe BMJ
BMJ. 2008 January 5; 336(7634): 10.
PMCID: PMC2174749
Disseminating Guidance

You’ll find it on the intranet

Alice Z Harney, F2 doctor, accident and emergency medicine

I agree with Lewis about the vital importance of disseminating guidance adequately.1 While working as a junior doctor on the wards, I have often thought to myself, “I’m sure there must be a hospital policy for this,” but I could never locate the relevant folder or navigate the depths of the intranet to find what I was looking for in the time available.

I recently completed an audit of a process that I felt wasn’t working well—only afterwards to be presented with a policy devised several years ago which had been dug up from the archives (and no, it wasn’t on the intranet) and consisted almost entirely of the changes I had recommended.

In contrast, one of the consultants at our accident and emergency department has produced a fantastic set of guidelines, providing a wealth of practical information for the staff. They are clear and concise, evidence based, accessible on every computer in the department, and so easy to use that anyone could work out from the Ottawa rules whether or not he needs his ankle injury x rayed.

So policy, guideline, protocol and pathway-writers take note: unless people can access your work easily and quickly, and know it exists, you may as well have not written it at all.


Competing interests: None declared.


1. Lewis DM. Please can we have some courageous leadership. BMJ 2007;335:1213 (8 December.) doi:10.1136/bmj.39419.666042.59

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