Academic journal article Australian Health Review

The Experience of Australian Project Leaders in Encouraging Practitioners to Adopt Research Evidence in Their Clinical Practice

Academic journal article Australian Health Review

The Experience of Australian Project Leaders in Encouraging Practitioners to Adopt Research Evidence in Their Clinical Practice

Article excerpt

Abstract

Objective: This paper describes a qualitative program evaluation which sought to identify factors that either assist or impede the adoption of clinical evidence in everyday practice.

Design and Participants: Thirteen Australian projects were funded in a competitive grant program to adopt innovative strategies to improve the uptake of research evidence in everyday clinical practice. Project leaders' reports were analysed to collate common themes related to 1) critical elements in successful application of research knowledge, 2) barriers to implementing evidence, and 3) lessons for other organisations that might implement a similar project.

Results: Despite the diversity of the methods used to establish projects and the range of topics and clinical settings, many similarities were identified in the perceived critical success elements, barriers, and lessons for adopting clinical evidence. Eighteen themes emerged across the data including: leadership support; key stakeholder involvement; practice changes; communication; resources; education of staff; evaluation of outcomes; consumers; knowledge gaps; adoption/implementing staff; access to knowledge; risk assessment; collaboration; effectiveness of clinical research evidence; structure/organisation; cultural barriers; previous experiences; and information technology.

Conclusion: Leaders of projects to adopt evidence in clinical practice identified barriers, critical success elements and lessons that impacted on their projects. A range of influences on the adoption of evidence were identified, and this knowledge can be used to assist others undertaking similar projects.

Aust Health Rev 2006: 30(4): 474-484

THERE ARE WELL DOCUMENTED gaps between research evidence and practice.1-4 The reasons for these gaps are complex and multifaceted. Barriers to the use of evidence in practice can occur at the level of the individual, team, organisation or system.5 These barriers vary with the clinical setting, format and nature of the evidence.6 The effectiveness of different interventions to change clinician behaviour, with respect to use of evidence, also vary when applied across different settings and contexts.7,8

It is likely that the success of efforts to increase use of evidence in practice could be improved by building an understanding of the barriers for the specific context, and systematically addressing these, while taking advantage of factors supporting the adoption of evidence.9,10 This paper is an exploration of these influences on the adoption of evidence, as perceived by project leaders undertaking evidence implementation projects in the Australian health care setting. This evaluation is based on the analysis of reports from 13 projects funded through the National Institute of Clinical Studies (NICS) targeted grants program to explore effective ways to address gaps between the available clinical evidence and its adoption in everyday practice. The aim of this paper is to identify factors that project leaders perceived as influencing the adoption of research evidence in clinical practice within the Australian health care setting.

Methods

The grant program

In 2001 and 2002, NICS offered grants ranging from $10 000 to $100 000 to organisations and individuals undertaking work in targeted areas: identifying or testing ways to increase the use of clinical evidence; improving patient care by implementing existing research knowledge; and reviewing research knowledge on uptake of known beneficial interventions. NICS received 394 applications for funding. All applications were assessed by a panel of experts with specialist knowledge in relevant clinical areas and implementation expertise from across the Australian health care sector. Eighteen projects were selected for funding,11-20 13 of which sought to adopt research evidence in various health care settings. These 13 evidence implementation projects are listed in Box 1, and form the basis of this paper. …

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