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Article
Publication date: 16 November 2015

Ann Dadich, Penny Abbott and Hassan Hosseinzadeh

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many…

Abstract

Purpose

Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice.

Design/methodology/approach

A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare – namely, a clinical aide and online training.

Findings

The perceived impact of both resources was determined by views on relevance and design – particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues.

Research limitations/implications

This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare.

Practical implications

Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited.

Originality/value

Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.

Details

Journal of Health Organization and Management, vol. 29 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 7 October 2011

Melanie Kazman Kohn, Whitney Berta, Ann Langley and David Davis

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of…

Abstract

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

Book part
Publication date: 12 August 2014

Susan Albers Mohrman and Michael Kanter

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the…

Abstract

Purpose

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

Methodology/approach

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

Findings

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Social/practical implications

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

Originality/value of paper

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

Details

Reconfiguring the Ecosystem for Sustainable Healthcare
Type: Book
ISBN: 978-1-78441-035-3

Keywords

Article
Publication date: 1 September 2000

E.H. Collier and S. Pyke

The paper outlines a model for addressing clinical effectiveness, and an illustration of how this is practically implemented through team working in a multidisciplinary…

1049

Abstract

The paper outlines a model for addressing clinical effectiveness, and an illustration of how this is practically implemented through team working in a multidisciplinary in‐patient environment. This is particularly relevant given the number of recent reports that highlight the need to develop and invest in the in‐patient services. The difficulty in implementing evidence‐based practice for mental health interventions is also addressed and initiatives being developed to enable a realistic approach in such an environment are described. The paper describes a structure and a process, using examples from audit, research and other initiatives particular to the unit, in providing accessible evidence based interventions for ward based staff, and improved clinical effectiveness generally.

Details

British Journal of Clinical Governance, vol. 5 no. 3
Type: Research Article
ISSN: 1466-4100

Keywords

Article
Publication date: 1 October 2004

Alistair Hewison

The rise of evidence‐based medicine and more recently evidence‐based policy reflect the increasing importance of evidence as a basis for the organisation and delivery of…

2224

Abstract

The rise of evidence‐based medicine and more recently evidence‐based policy reflect the increasing importance of evidence as a basis for the organisation and delivery of health care. Evidence‐based practice is central to the “modernisation” of health care in current UK policy. The latest manifestation of this process is the emergence of evidence‐based management in health care. This paper examines the development of evidence‐based approaches in health care and questions the appropriateness of such an approach to management. The problems inherent in applying the principles of EBP to management are explored and alternative apporoach based on the notion of craft is suggesteed as more practical and realistic.

Details

Journal of Health Organization and Management, vol. 18 no. 5
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 9 August 2011

Michael Ogundele

This article aims to review the available literature on how clinicians meet the daily challenge of translating medical information into clinical EBM. It also seeks to…

1035

Abstract

Purpose

This article aims to review the available literature on how clinicians meet the daily challenge of translating medical information into clinical EBM. It also seeks to describe the procedures involved in a local initiative in the UK to develop software applications for implementation of national clinical guidelines to enhance EBM in routine clinical practice.

Design/methodology/approach

It was hypothesised that improved access to these guidelines in routine clinical practice could be achieved through integrated local procedures, thereby enhancing the quality of care provided to children and adolescents with asthma or UTI. A literature search was performed using databases. To explore the preferences of the doctors and other healthcare professionals on how they accessed clinical guidelines, feedback was obtained. Stepwise implementation of the clinical guidelines was instituted over a period of three years in different primary care and hospital settings.

Findings

The professionals actively engaged with all the different stages in the implementation of the clinical guidelines. The majority preferred the interactive computerized system based on its ease of use, better aesthetic features, familiarity with the software and limited dependence on the technical skills of the users.

Research limitations/implications

The limitations of this study include lack of systematic data to assess the clinical effectiveness of the guidelines' implementation. Another apparent limitation of the study is the small size of participants within the paediatric unit of each organisation where the study was conducted.

Practical implications

There is a need for further comparative studies between the local intervention strategies described in this study and other implementation strategies, to identify the most effective implementation methods for electronic guideline‐based systems.

Social implications

Reliable high quality guidelines from reputable professional bodies could be successfully implemented at the primary or hospital‐based levels through a series of coordinated multidisciplinary interactive processes. This study has positive implications for improving the quality of care provided to children and adolescents, enhancing the role of clinical governance, provision of useful information to patients/carers and other healthcare providers.

Originality/value

This study highlights a potentially effective way of implementing and integrating an electronic guideline‐based computer system into local practice.

Article
Publication date: 1 January 1997

Lesley A. Page

Important shifts in policy and practice, the shift to woman‐centred services, the recognition that midwives should be lead clinician in a number of cases, and the idea of…

Abstract

Important shifts in policy and practice, the shift to woman‐centred services, the recognition that midwives should be lead clinician in a number of cases, and the idea of effective care, are leading to fundamental change in the maternity services. For many years, midwives have shown interest in the idea of evidence‐based or effective care. There are a number of good reasons for the interest in evidence‐based care. However, unless the political reality of the difficulties of the change are faced, the changes will remain rhetorical, virtual rather than real. Midwifery holds the potential for using evidence in practice, and for improving health outcomes for mothers and babies. If the status quo is not challenged, an important opportunity will have been missed.

Details

Journal of Clinical Effectiveness, vol. 2 no. 1
Type: Research Article
ISSN: 1361-5874

Book part
Publication date: 28 December 2006

Abram Rosenblatt and Laura Compian

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral…

Abstract

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders, they did so from perspectives so different as to appear diametrically opposed. Service systems exist at multiple levels, including the practice, program, and system levels (Rosenblatt, 1988, 2005; Rosenblatt & Woodbridge, 2003). Research on health and mental health service systems similarly varies, often by level of the service system, with the research methods, independent and dependent variables, populations of interest, and ultimately the consumers of the research product interacting differentially in the creation and understanding of what constitutes a knowledge base for service delivery. Systems of care and, with limited exceptions, evidence-based practices exist at different levels of the service delivery structure, require and derive from different research approaches, and speak to overlapping but historically different audiences.

Details

Research on Community-Based Mental Health Services for Children and Adolescents
Type: Book
ISBN: 978-1-84950-416-4

Article
Publication date: 1 August 2001

Jane Farmer and Rosemary Chesson

Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of…

1768

Abstract

Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and the other for GPs, are presented. These include critical success factors in achieving evidence‐based commissioning and factors that are likely to predispose and precipitate evidence‐based practice. Given a culture demanding transparency, accountability and continuing improvement, the models provide tools for reflection, evaluation and planning. In addition, they identify a pragmatic role for managers in evidence‐based commissioning and provide a framework for audit.

Details

Journal of Management in Medicine, vol. 15 no. 4
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 13 November 2009

Robin A. Paynter

The purpose of this paper is to outline increased use of evidence‐based research strategies in the applied social sciences.

2303

Abstract

Purpose

The purpose of this paper is to outline increased use of evidence‐based research strategies in the applied social sciences.

Design/methodology/approach

The paper documents an ideal procedure for researchers to follow. It also provides resources from which to find evidence.

Findings

Evidence‐based practice is emerging as an influential field within academic and professional applied social science fields; as such, reference librarians across various library types should become familiar with the search strategies and tools their users need in order to be successful evidence‐based practice researchers

Originality/value

The Campbell Collaboration's motto, “What helps? What harms? Based on what evidence?” neatly sums up the field of evidence‐based practice research

Details

Reference Services Review, vol. 37 no. 4
Type: Research Article
ISSN: 0090-7324

Keywords

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