Bridging the gap between basic science and clinical practice: The role of organizations in addressing clinician barriers

Beckett, Megan K.; Quiter, Elaine; Ryan, Gery W.; Berrebi, Claude; Taylor, Stephanie L.; Cho, Michelle; Pincus, Harold Alan; Kahn, Katherine L.

doi:10.1186/1748-5908-6-35

Cited by 32 publications

(32 citation statements)

References 25 publications

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“…Although the field of implementation science strives to address the recognised gap between knowledge generated in clinical trials and routine clinical practice,1 2 research has demonstrated significant delays in the diffusion and adoption of effective, evidence-based clinical practices 3 4. Closing this gap still remains a challenge for many health systems.…”

Section: Introductionmentioning

confidence: 99%

Project JOINTS: What factors affect bundle adoption in a voluntary quality improvement campaign?

et al. 2014

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Background Diffusion and adoption of effective evidence-based clinical practices can be slow, especially if complex changes are required to implement new practices. Objective To examine how hospital adherence to quality improvement (QI) methods and hospital engagement with a large-scale QI campaign could facilitate the adoption of an enhanced prevention bundle designed to reduce surgical site infection (SSI) rates after orthopaedic surgery (hip and knee arthroplasty). Methods We conducted telephone interviews with hospital QI leaders from 73 of the 109 hospitals (67% response rate) in five states that participated in Project JOINTS (Joining Organizations IN Tackling SSIs), a QI campaign run by Institute for Healthcare Improvement (IHI). Using QI methods grounded in the IHI Model for Improvement, this campaign encouraged hospitals to implement an enhanced SSI prevention bundle. Hospital QI leaders reported on their hospital's adherence to the Project JOINTS QI methods; their level of engagement with Project JOINTS activities; and adoption of the SSI prevention bundle components. Interview data were analysed quantitatively and qualitatively. Results Both adherence to the QI methods and hospital engagement were positively associated with complete bundle adoption. Hospital engagement, especially the use of project materials and tools, was also positively associated with the initiation of and improved adherence to individual bundle components. Conclusions Our findings suggest that greater adherence to the QI methods and active hospital engagement in a QI campaign facilitate adoption of evidence-based patient safety bundles in orthopaedic practice.

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Section: Introductionmentioning

confidence: 99%

Project JOINTS: What factors affect bundle adoption in a voluntary quality improvement campaign?

et al. 2014

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“…10,90,91 On the other hand, elements that foster effective translation of best evidence into daily practice are influenced by nurses' understanding and believing that EBP improves patient care outcomes, clinical leaders' modeling EBP in daily practice, and a culture that supports practice change based on best evidence. 10,11 It is time to change the culture in our critical care units to one that embraces the translation of evidence into daily practice.…”

Section: Discussionmentioning

confidence: 99%

Continuing to Challenge Practice to Be Evidence Based

Makic

Rauen

Jones

et al. 2015

Critical Care Nurse

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E nsuring that we provide safe, evidence-based, cost-effective care to all patients is an assumption of today's health care system. All patients and health care providers should expect a health care system that is committed to preventing harm and improving patient care by having clinicians use evidence-based safe practices.1 The call for evidence-based practice (EBP) was made in the hallmark publication of the Institute of Medicine's report "To Err Is Human" more than a decade ago. Feature Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient's actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice. (Critical Care Nurse. 2015;35[2]:39-50)

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“…2 This translational gap – the time between identifying effective procedures or care protocols and the adoption and sustained use of that information in routine practice - consists of many barriers. 3,4, 5 For example, it has been documented that passive dissemination of knowledge (i.e. solely through publications) is unlikely to substantially change professional behavior.…”

Section: Introductionmentioning

confidence: 99%

Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research, CONDOR

McBride¹,

Lindblad

Williams

et al. 2013

Journal of Dentistry

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Objectives The National Institute of Dental and Craniofacial Research funded three practice-based research networks (PBRNs), NW-PRECEDENT, PEARL and DPBRN to conduct studies relevant to practicing general dentists. These PBRNs collaborated to develop a questionnaire to assess the impact of network participation on changes in practice patterns. This report presents results from the initial administration of the questionnaire. Methods Questionnaires were administered to network dentists and a non-network reference group. Practice patterns including caries diagnosis and treatment, pulp cap materials, third molar extraction, dentin hypersensitivity treatments and endodontic treatment and restoration were assessed by network, years in practice, and level of network participation.Test-retest reliability of the questionnaire was evaluated. Results 950 practitioners completed the questionnaire. Test-retest reliability was good-excellent (kappa>0.4) for most questions. Significant differences in responses by network were not observed. The use of caries risk assessment forms differed by both network participation (p<0.001) and years since dental degree (p=0.026). Recent dental graduates are more likely to recommend third molar removal for preventive reasons (p=0.003). Conclusions Practitioners in the CONDOR research networks are similar to their US colleagues. As a group, however, these practitioners show a more evidence-based approach to their practice. Dental PBRNs have the potential to improve the translation of evidence into daily practice. Designing methods to assess practice change and the associated factors is essential to addressing this important issue.

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Bridging the gap between basic science and clinical practice: The role of organizations in addressing clinician barriers

Cited by 32 publications

References 25 publications

Project JOINTS: What factors affect bundle adoption in a voluntary quality improvement campaign?

Project JOINTS: What factors affect bundle adoption in a voluntary quality improvement campaign?

Continuing to Challenge Practice to Be Evidence Based

Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research, CONDOR

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