A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study

Abstract

Background Healthcare settings are complex, and the decision-making process is usually complicated, too. Precise use of best evidence from different sources for increasing the desired outcomes is the result of EBM. Therefore, this study aimed to map the potential facilitators and barriers to EBM in health systems to help the healthcare managers to better implement EBM in their organizations. Methods The present study was a scoping review (SR) conducted in 2020 based on the integration of the frameworks presented by Arksey and O’Malley (2005) and Levac et al. (2010) considering the Joanna Briggs Institute guideline (2015). These frameworks consist of 6 steps. After finalizing the search strategy, 7 databases were searched, and the PRISMA-ScR was used to manage the retrieval and inclusion of the evidence. Microsoft Excel 2013 was used to extract the data, and the graphic description was presented. The summative analysis approach was used applying MAXQDA10. Results According to the systematic search, 4815 studies were retrieved after eliminating duplicates and unrelated articles, 49 articles remained to extract EBM facilitators and barriers. Six main aspects attitude toward EBM, external factors, contextual factors, resources, policies and procedures, and research capacity and data availability were summarized as EBM facilitators. The barriers to EBM were similarly summarized as attitude toward EBM, external factors, contextual factors, policies and procedures, limited resources, and research capacity and data availability. The streamgraphs describe that the international attention to the sub-aspects of facilitators and barriers of EBM has been increased since 2011. Conclusions The importance of decision-making regarding complex health systems, especially in terms of resource constraints and uncertainty conditions, requires EBM in the health system as much as possible. Identifying the factors that facilitate the use of evidence, as well as its barriers to management and decision-making in the organization, can play an important role in making systematic and reliable decisions that can be defended by the officials and ultimately lead to greater savings in organization resources and prevent them from being wasted.

Cultura organizacional para a mudança num contexto hospitalar: uma perspectiva de enfermagem

“…Na dimensão "Conteúdo da Mudança", consideramos as atitudes dos participantes perante a gestão da mudança, como positivas, tendo em conta a evidência consultada, (23)(24)(25) que mapeia a confiança, pessoal e interpessoal, a consciencialização e reconhecimento da necessidade para a mudança, os valores e expetativas, como determinantes facilitadores da gestão da mudança.…”

“…A interpretação destes resultados permite destacar atitude favorável dos profissionais face à mudança, considerando a utilização da evidência como um valor organizacional, em oposição a falta de confiança acerca do valor e da qualidade da evidência, ou mesmo a resistência para a mudança, considerados como barreiras para a implementação da evidência. (23) Porém, nas subdimensões da Monitorização, Avaliação e Feedback, percebemos que esta função instrumental da gestão é percebida pelos participantes como neutra, sugerindo uma percepção menos positiva das funções exercidas pelos enfermeiros gestores, o que se configura dificultador, tendo em conta que no âmbito organizacional, a monitorização, avaliação e disseminação dos resultados apresentam-se como componentes cruciais para a utilização de pesquisas na prática dos enfermeiros. (29) A dimensão da Motivação acumulou a segunda pior média, logo atrás da dimensão da Liderança.…”

How COVID-19 affects the use of evidence informed policymaking among iranian health policymakers and managers

“…That body of research has also shown that policymakers have always encountered many barriers to EIPM; including a lack of available timely evidence, insufficient skills in retrieving and interpreting evidence and lack of access to evidence (including relationships with the producers of evidence). The established literature on EIPM offers some insights into how EIPM can be increased [ 4 ], such as are having access to research publications; having summaries and synthesis of policy relevant evidence, including policy briefs; [ 5 ] upskilling decision makers to be able to understand and interpret scientific evidence; increasing the level interaction between researchers and policymakers; and having supportive and organizational culture that value the use of evidence [ 6 , 7 ]. The literature has also emphasized the need for developing a stronger bridge between research bodies and policymakers through organizing Knowledge Brokers (KBs)[ 8 ].…”

Dissemination of Evidence by Cochrane Public Health Europe in German-Speaking Countries: An Online Stakeholder Survey

“…Translating such knowledge can be facilitated when the accessible evidence is high quality, understandable and appropriately disseminated to relevant stakeholder groups [9,10]. Ideally, end-users' evidence needs are already known before any knowledge translation activity begins: a recent survey of social security and insurance medicine professionals in the European Union showed that synthesised evidence based on primary research, as reported in guidelines and systematic reviews, is more often needed for their work than primary study evidence alone [11].…”