Affiliation CNWL-Milton Keynes Lay summary Name Nina Soloff Affiliation CNWL-Milton Keynes Lay summary The Milton Keynes’ whole-system approach to quality improvement, clinical effectiveness and evidence-based practice: links care pathways and packages with the evidence-base enables outcome measurement in relation to each package of care Question/Rationale The difficulties of embedding evidence-based practice into clinical work are well-documented. A system which integrated the evidence-base with service delivery (packages of care) was required. We updated the pathways and packages and electronically embedded the evidence within them... What did you do? We held evidence-based clinical discussions... We defined our care pathways and packages... What did you find out? There was great variety of practice prior to clinical discussions. Although worthwhile, evidence-based clinical discussions are time-consuming, and difficult to maintain at a service level. The work is never complete: there needs to be an ongoing programme of review. Next steps: Audit practice and outcomes in relation to packages/evidence-base Implications: Improvements in quality and equity of service Potential to identify gaps in the evidence-base