Barriers and Strategies for Implementing Knowledge in to Health System Management: A Qualitative Study

Abstract

Background:The gap between knowledge and practice is a global issue that reduces service quality by creating barriers to knowledge implementation, and thus strategies should be developed to resolve it. The present study aimed to explain barriers and strategies for implementing knowledge implementation into Iranian health system management. Methods: This qualitative study was conducted on 53 managers and health management graduates in 2018. Participants were recruited through purposive sampling in Medical Sciences Universities in Iran. Data were collected by semi-structured interviews based on the "Promoting Action on Research Implementation (PARiHS)" framework, focus group discussions and Delphi technique. The PARiHS framework has three main elements including; evidence, context and facilitation. The Lincoln and Guba criterion was used to assess the rigor of the study. Data were analyzed in MAXQDA software version 10 using directional content analysis. Results: After data analysis 9 subcategories and 3 main categories including; evidence, context, and facilitation were emerged. In addition to three subcategories including, culture, leadership and evaluation, the socio-political subcategory was a context for knowledge implementation main barrier in the organizational context. The systematic structural planning for the combined use of four sources of knowledge is the most important strategy. Conclusion:The lack of context readiness in using knowledge and lack of efficient system impeded knowledge implementation in the health system management. Therefore, managers and policy makers need to design a comprehensive system based on current knowledge and successful experiences.

A knowledge implementation model in health system management based on the PARIHS model

“…Finally, in the third stage, 135 strategies were approved by the participants as final strategies for removing the existing barriers in the route of knowledge implementation in the health system management of the country. The section on barriers and strategies for knowledge implementation was already published in an article entitled "Barriers and Strategies for Implementing Knowledge into Health System Management: A Qualitative Study" [26].…”

“…In the third stage, we sent the extracted strategies from the previous stage to the panel to prioritize them based on the second-stage criteria. After we received the results, we found that the number of participants at the beginning of the study was 33, whereas only 25 replied to the emails [25,26].…”