Health services can and should be improved by applying research findings about best practice. Yet, in Knolwedge to Action?, the authors explore why it nevertheless proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures.The book draws on a large body of evidence acquired in the course of nearly fifty in-depth case studies, following attempts to introduce evidence-based practice in the UK NHS over more than a decade. Using qualitative methods to study hospital and primary care settings, they are able to shed light on why some of these attempts succeeded where others faltered. By opening up the intricacies and complexities of change in the NHS, they reveal the limitations of the simplistic approaches toimplementing research or introducing evidence-based health care.A unique synthesis of evidence, the book brings together data from 1,400 interviews with doctors, nurses, and managers, as well as detailed observations and documentary analysis. The authors provide an analysis, rooted in a range of theoretical perspectives, that underlines the intimate links between organizational structures and cultures and the utilization of knowledge, and draws conclusions which will be of significance for other areas of public management. Their findings have implicationsfor the utlization of knowledge in situations where there is a professional tradition working within a politically sensitive blend of public service, managerial accountability, and technical expertise.Knowledge to Action? will be of interest to Academics, Researchers, and Advanced Students of Organizational Behaviour, Public and Health Management, and Evidence-Based Medicine; and also of particular interest to Practitioners, Clinicians, and Public Health Managers concerned with implementing change to clinical practice.

Health care systems worldwide are faced with the challenge of improving the quality of care. Providing evidence from health research is necessary but not sufficient for the provision of optimal care and so knowledge translation (KT), the scientific study of methods for closing the knowledge-to-action gap and of the barriers and facilitators inherent in the process, is gaining significance. Knowledge Translation in Health Care explains how to use research findings to improve health care in real life, everyday situations. The authors define and describe knowledge translation, and outline strategies for successful knowledge translation in practice and policy making. The book is full of examples of how knowledge translation models work in closing the gap between evidence and action. Written by a team of authors closely involved in the development of knowledge translation this unique book aims to extend understanding and implementation worldwide. It is an introductory guide to an emerging hot topic in evidence-based care and essential for health policy makers, researchers, managers, clinicians and trainees.

The Evidence-Based Nursing Series is co-published with Sigma Theta Tau International (STTI). The series focuses on implementing evidence-based practice in nursing and mirrors the remit of Worldviews on Evidence-Based Nursing, encompassing clinical practice, administration, research and public policy. Models and Frameworks for Implementing Evidence- Based Practice: Linking Evidence to Action looks at ways of implementing evidence gained through research and factors that influence successful implementation. It acknowledges the gap that exists between obtaining evidence and the practicalities of putting it into practice and provides direction to help to close this gap. This, the first book in the series, helps the reader to make decisions about the appropriateness of using various models and frameworks. A selection of models and frameworks are examined in detail including examples of their use in practice. The book concludes with an analysis and synthesis of the included models and frameworks. The models and frameworks that have been included are based on a number of criteria: that they are internationally recognised, have undergone widespread evaluation and testing, are transferable across different settings, and can be used by different disciplines. Models and frameworks include: Stetler Model Ottowa Model of Research Use IOWA model of evidence-based practice Advancing Research and Clinical Practice through Close Collaboration (ARCC) model Dobbins’ dissemination and use of research evidence for policy and practice framework Joanna Briggs Institute model Knowledge to Action framework Promoting Action on Research Implementation in Health Services (PARIHS) Key Points: Includes an overview of implementation issues and the use of theory and frameworks in implementing evidence into practice Chapters are written by the developers of the model or framework Each chapter provides background on an implementation model or framework, suitable applications, underlying theory and examples of use Each chapter examines strengths and weaknesses of each model alongside barriers and facilitators for its implementation

Health services can and should be improved by applying research findings about best practice. Yet, in Knowledge to Action?, the authors explore why it nevertheless proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures. The book draws on a large body of evidence acquired in the course of nearly fifty in-depth case studies, following attempts to introduce evidence-based practice in the UK NHS over more than a decade. Using qualitative methods to study hospital and primary care settings, they are able to shed light on why some of these attempts succeeded where others faltered. By opening up the intricacies and complexities of change in the NHS, they reveal the limitations of the simplistic approaches to implementing research or introducing evidence-based health care. A unique synthesis of evidence, the book brings together data from 1,400 interviews with doctors, nurses, and managers, as well as detailed observations and documentary analysis. The authors provide an analysis, rooted in a range of theoretical perspectives, that underlines the intimate links between organizational structures and cultures and the utilization of knowledge, and draws conclusions which will be of significance for other areas of public management. Their findings have implications for the utilization of knowledge in situations where there is a professional tradition working within a politically sensitive blend of public service, managerial accountability, and technical expertise. Knowledge to Action? will be of interest to Academics, Researchers, and Advanced Students of Organizational Behaviour, Public and Health Management, and Evidence-Based Medicine; and also of particular interest to Practitioners, Clinicians, and Public Health Managers concerned with implementing change to clinical practice.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.

There are at least three ways in which a public health program or policy may not reach stated goals for success: 1) Choosing an intervention approach whose effectiveness is not established in the scientific literature; 2) Selecting a potentially effective program or policy yet achieving only weak, incomplete implementation or "reach," thereby failing to attain objectives; 3) Conducting an inadequate or incorrect evaluation that results in a lack of generalizable knowledge on the effectiveness of a program or policy; and 4) Paying inadequate attention to adapting an intervention to the population and context of interest To enhance evidence-based practice, this book addresses all four possibilities and attempts to provide practical guidance on how to choose, carry out, and evaluate evidence-based programs and policies in public health settings. It also begins to address a fifth, overarching need for a highly trained public health workforce. This book deals not only with finding and using scientific evidence, but also with implementation and evaluation of interventions that generate new evidence on effectiveness. Because all these topics are broad and require multi-disciplinary skills and perspectives, each chapter covers the basic issues and provides multiple examples to illustrate important concepts. In addition, each chapter provides links to the diverse literature and selected websites for readers wanting more detailed information. An indispensable volume for professionals, students, and researchers in the public health sciences and preventative medicine, this new and updated edition of Evidence-Based Public Health aims to bridge research and evidence with policies and the practice of public health.