The value of evidence in change

Famous Florentine writer, philosopher and historian Niccolò Machiavelli once said that, ‘there is nothing more difficult to carry out nor more doubtful of success nor more dangerous to handle, than to initiate a new order of things’ (Machiavelli, 1513). Putting research findings into practice has become increasingly recognised as a high priority among researchers and policy-makers (Foy et al, 2015); however, implementing change in organisations has historically been a complex and dynamic process that is not always successful. Balasubramanian et al (2015) suggested that change in healthcare is often focused on outcomes or targets, bypassing the educational aspect, and that individuals may be reluctant to amend their practice if they are unaware of the evidence that supports it.

Maternity services have seen several changes in recent years as a result of research findings or from the development of new technology, medicines and equipment. Significant national reviews of maternity services, such as Kirkup (2015), also have an effect on practice: often recommendations from these reviews are a high priority when it comes to making changes in maternity services, as evidenced by the publication of Better Births (National Maternity Review, 2016).