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Saturday, 29 October 2011
Learning Objective 1: 1) To describe a model for implementing evidence-based practice changes in complex healthcare systems
Learning Objective 2: 2) To discuss implementation strategies to use across phases of implementation
Expectations for provision of evidence-based healthcare continue to grow. The most difficult step in the evidence-based practice process is implementation of the practice change. A number of evidence-based practice models are available, yet guidance for implementation is not sufficient within these models. The Evidence-Based Practice Implementation Model provides direction for this difficult step in the evidence-based practice process. Use of an implementation model provides direction for nursing leaders responsible for leading adoption of clinical practice recommendations in complex healthcare systems. Implementation strategies are arranged in four phases to facilitate the systematic use of effective strategies to promote provision of evidence-based healthcare. The model provides implementation strategies to guide the team moving from creating awareness and interest, to building knowledge and commitment, promoting action and adoption, through pursuing integration and sustained use of the practice change. Implementation strategies used to generate awareness and interest in an evidence-based practice change must capture the attention of busy clinicians. Implementation strategies that build knowledge and commitment are selected to promote clinicians having a positive attitude and knowledge about the practice change. Implementation strategies that promote action and adoption support behavior change so clinicians use the evidence-based practice recommendations to improve patient care. The integration and sustained use phase of adoption is designed to hard-wire the practice change into clinician’s workflow, ensuring consistent use of the evidence-based practice. Implementation strategies are arranged to target either clinicians and leaders or the social system/context to facilitate provision of evidence-based healthcare. This practical model includes strategies tested through implementation science and other practical but less well tested strategies to support application in practice. Application of existing empirical evidence from implementation science is essential. The Evidence-Based Practice Implementation Model provides a practical and application oriented resource for practitioners and organizational leaders.