Awareness of evidence-based practices alone does not translate to implementation

Insights from implementation research

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

This article offers a scholarly review and perspective on the potential of "implementation research" to generate incremental, context-sensitive, evidence-based management strategies for the successful implementation of evidence-based practices (EBPs) (such as the "central line bundle"). Many hospitals have difficulty consistently implementing EBPs at the unit level. This problem has been broadly characterized as "change implementation failure" in health care organizations. The popular hospital response to this challenge has been to raise clinician awareness of EBPs through mandated educational programs. However, this approach has not always succeeded in changing practice. The health services research literature has emphasized the role of several organizational variables (eg, leadership, safety culture, organizational learning, teamwork and communication, and physician/staff engagement) in successful change implementation. Correspondingly, this literature has developed broad frameworks and programs for change in health care organizations. While these broad change frameworks have been successfully applied by some facilities to change practice, they are not incrementally actionable. As such, several facilities have not leveraged broad change frameworks because of resource and/or contextual limitations; a majority of hospitals continue to resort to mandated clinician education (awareness-building) for change implementation. The recent impetus toward "implementation research" in health care has the potential to generate incremental, context-sensitive, evidence-based management strategies for practice change. Authors discuss specific insights from a recently completed study on central line bundle implementation in 2 intensive care units in an academic health center. The study demonstrates that awareness of EBPs alone does not translate to implementation. More importantly, the study also identifies incremental, context-sensitive, evidence-based management strategies for successful implementation of EBPs at the unit level.

Original languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalQuality management in health care
Volume22
Issue number2
DOIs
StatePublished - Apr 1 2013

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research implementation
Evidence-Based Practice
Research
Health Services Research
evidence
Organizations
Delivery of Health Care
Safety Management
health care
Practice Management
management
Intensive Care Units
Communication
Learning
Physicians
learning organization
Education
teamwork
educational program
Health

Keywords

  • Change implementation
  • Culture of safety
  • Evidence-based management strategies
  • Evidence-based practices
  • Implementation research
  • Mandated hospital education

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy
  • Care Planning

Cite this

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abstract = "This article offers a scholarly review and perspective on the potential of {"}implementation research{"} to generate incremental, context-sensitive, evidence-based management strategies for the successful implementation of evidence-based practices (EBPs) (such as the {"}central line bundle{"}). Many hospitals have difficulty consistently implementing EBPs at the unit level. This problem has been broadly characterized as {"}change implementation failure{"} in health care organizations. The popular hospital response to this challenge has been to raise clinician awareness of EBPs through mandated educational programs. However, this approach has not always succeeded in changing practice. The health services research literature has emphasized the role of several organizational variables (eg, leadership, safety culture, organizational learning, teamwork and communication, and physician/staff engagement) in successful change implementation. Correspondingly, this literature has developed broad frameworks and programs for change in health care organizations. While these broad change frameworks have been successfully applied by some facilities to change practice, they are not incrementally actionable. As such, several facilities have not leveraged broad change frameworks because of resource and/or contextual limitations; a majority of hospitals continue to resort to mandated clinician education (awareness-building) for change implementation. The recent impetus toward {"}implementation research{"} in health care has the potential to generate incremental, context-sensitive, evidence-based management strategies for practice change. Authors discuss specific insights from a recently completed study on central line bundle implementation in 2 intensive care units in an academic health center. The study demonstrates that awareness of EBPs alone does not translate to implementation. More importantly, the study also identifies incremental, context-sensitive, evidence-based management strategies for successful implementation of EBPs at the unit level.",
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