| 1. |
Approach to implement
evidence is evidence-based: |
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| Evidence
on implementing research (changing practice) |
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Research
base incomplete - possible to make informed judgements on how
best to influence behaviour of health professionals |
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Use systematic
approaches and involve strategic planning |
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First step
= diagnostic analysis - used to inform design and content of
plans |
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Successful
strategies are likely to be broad based and multi-facetted |
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Ensure
appropriate training provided for all involved |
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Change
unlikely to occur unless people with necessary skills &
knowledge exist to lead and apply all components of the strategy |
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Include
plans to monitor and evaluate change |
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Include
methods to maintain and reinforce change |
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Source = CRD
(1999) Getting Evidence into Practice. Effective Health Care Bulletin
5(1). |
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| 2. |
Lessons for implementation
of implementation of evidence into clinical practice derived from
different approaches to change. |
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| Approach |
Lessons
for implementation |
| Educational |
Involve
target group to discuss needs, experiences and ownership of
product |
| Epidemiological |
Develop
sound or credible message or product |
| Marketing |
Learn
about needs and problems of the target group: adapt innovation |
| Behaviorist |
Keep
in mind that most people seek reinforcement and rewards Make
life easier for target group: provide tools etc. |
| Social
Influences |
Use
respected peers, opinion leaders, role models as intermediaries
to promote use of the innovation |
| Organizational |
Be
aware that setting is often a barrier: Improve teamwork, and
leadership, provide resources and support, Restructure care
process; build innovation into routines |
| Coercive |
Keep
in mind that some target groups need some pressure to change:
Use regulation and budgets appropriately and careful to support
the change process |
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Source = Grol
R & Grimshaw J (1999) Evidence - Based implementation of Evidence
- Based Medicine. Journal on Quality Improvement, 25 (10) 503-513. |
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| 3. |
Action Planning
is a useful tool to make changes. |
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Developing
an action plan
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| Action
plans for implementing change need to consider the following
issues (use as heading) : |
| Objectives
/ Action to be taken (develop achievable milestones - with timescales) |
| Who are
the stakeholders - Who needs to know what - how will we communicate |
| Who will
do what on the project - do we need additional skills |
| What resources
are required by when |
| What are
the potential constraining forces - how can they be minimized |
| How will
we know whether the actions have been successful? (measurement) |
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Supervision
/ management arrangements
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| From :
Grundy T: (1993). Implementing Strategic Change. London. Kogan
Page. |
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| 4. |
Audit is a useful
tool to evaluate whether the changed practice is achieving the result
we want. In order to learn more about audit, please refer to Quality
Assurance of our site. |
