Enabling the implementation of evidence based practice: a conceptual framework.

The argument put forward in this paper is that successful implementation of research into practice is a function of the interplay of three core elements--the level and nature of the evidence, the context or environment into which the research is to be placed, and the method or way in which the process is facilitated. It also proposes that because current research is inconclusive as to which of these elements is most important in successful implementation they all should have equal standing. This is contrary to the often implicit assumptions currently being generated within the clinical effectiveness agenda where the level and rigour of the evidence seems to be the most important factor for consideration. The paper offers a conceptual framework that considers this imbalance, showing how it might work in clarifying some of the theoretical positions and as a checklist for staff to assess what they need to do to successfully implement research into practice.

[1]  P. Senge The leader's new work: Building learning organizations. , 1998 .

[2]  S. Piereson,et al.  In Search of Excellence: Lessons from America's Best-Run Companies. By Thomas J. Peters and Robert H. Waterman, Jr. New York: Harper & Row, 1982 , 1983 .

[3]  D M Berwick,et al.  Continuous improvement as an ideal in health care. , 1989, The New England journal of medicine.

[4]  I M King,et al.  Planning for change , 2020, A New World-System.

[5]  J. Lomas Teaching old (and not so old) docs new tricks , 1993 .

[6]  G. Abi-Aad,et al.  Turning evidence into everyday practice. , 1997, Nursing times.

[7]  A. Haines,et al.  Implementing findings of research , 1994, BMJ.

[8]  Peter F. Drucker,et al.  Managing for the Future , 1992 .

[9]  K. Seers,et al.  From research to practice: one organizational model for promoting research-based practice. , 1996, Journal of advanced nursing.

[10]  N. Cullum,et al.  Identification and analysis of randomised controlled trials in nursing: a preliminary study. , 1997, Quality in health care : QHC.

[11]  H. Hearnshaw,et al.  Multidisciplinary audit in primary healthcare teams: facilitation by audit support staff. , 1994, Quality in health care : QHC.

[12]  R. Neville,et al.  Controlled trial of an audit facilitator in diagnosis and treatment of childhood asthma in general practice , 1995, BMJ.

[13]  A. Kitson,et al.  Achieving improvement through quality: an evaluation of key factors in the implementation process. , 1996, Journal of advanced nursing.

[14]  D. Sackett,et al.  Inpatient general medicine is evidence based , 1995, The Lancet.

[15]  D. Sackett,et al.  Evidence based medicine: what it is and what it isn't , 1996, BMJ.

[16]  Donald A. Schön,et al.  Theory in Practice: Increasing Professional Effectiveness , 1974 .

[17]  Karl E. Weick,et al.  The planning of change. 3rd ed. , 1977 .

[18]  A. Kitson From research to practice: one organisational model for promoting research based practice. , 1997, EDTNA-ERCA Journal.

[19]  D. Burrows Facilitation: a concept analysis. , 1997, Journal of advanced nursing.

[20]  W. Edwards Deming,et al.  Out of the Crisis , 1982 .

[21]  D. Schoen Educating the reflective practitioner , 1987 .