An Evidence-Based Approach to Successful Practice Change, the Toolkit: Implementation of Best Practice Guidelines

An evidence-based practice program, funded by a provincial government and led by a professional nursing association in Canada, has a mandate to develop, disseminate, and support the uptake and evaluation of clinical and healthy work environment best practice guidelines.  This program has achieved global reach, a success due to its rigorous guideline development process, and innovative multi-pronged implementation strategies. These strategies are focused at the individual, organizational and system level, and incorporate evidence-based approaches to support the implementation of best practices.  A key resource that is utilized within this program to guide the systematic implementation process of best practices is the Toolkit: Implementation of Best Practice Guidelines. This framework, based on implementation science, presents a planned change approach designed to assist nurses and other health-care professionals support evidence-informed clinical decision-making.

This Toolkit is based on the Knowledge to Action Framework and emerging evidence that the likelihood of achieving successful uptake of best practice in health care increases when:

•        Guidelines are selected for implementation through  systematic, participatory processes including relevant stakeholder engagement and environmental readiness assessment

•        Guidelines are tailored to the local context

•        Barriers and facilitators to guideline use are assessed and addressed

•        Guideline use is systematically monitored and sustained

•        Evaluation of the impacts of guideline use is an integral part of the entire process

•        There are adequate resources to support completion of all aspects of implementation

The Toolkit:  Implementation of Best Practice Guidelines will help guideline users and implementers take best evidence and integrate it into practice, education and policy using a systematic approach consistent with the local context of practice. This presentation will share the key phases of guideline implementation outlined in the Toolkit, and discuss how this resource is being utilized to successfully address the key challenges of developing evidence-based practice cultures through guideline implementation.