Leadership in evidence-based practice: a systematic review

Abstract

1 Structured Abstract:Purpose: We aimed to systematically review published empirical research on leadership as a determinant for the implementation of evidence-based practice (EBP) and to investigate leadership conceptualization and operationalization in this field. Design/methodology/approach: A systematic review with narrative synthesis was conducted. Relevant bibliographic databases and reference lists of pertinent review articles were searched. To be included, a study had to involve empirical research and refer to both leadership and EBP in health care. Study quality was assessed with a structured instrument based on study design. Findings: A total of 17 studies were included. Leadership was mostly viewed as a modifier for implementation success, acting through leadership support. Yet, there was definitional imprecision as well as conceptual inconsistency and studies seemed to inadequately address situational and contextual factors. Although referring to an organizational factor, the concept was mostly analysed at the individual or group level. Research limitations/implications:The concept of leadership in implementation science seems to be not fully developed. It is unclear whether attempts to tap the concept of leadership in available instruments truly capture and measure the full range of the diverse leadership elements at various levels. Research in implementation science would benefit from a better integration of research findings from other disciplinary fields. Once a more mature concept has been established, researchers in implementation science could proceed to further elaborate operationalization and measurement. Originality/value Although the relevance of leadership in implementation science has been acknowledged, the conceptual base of leadership in this field has received only limited attention. KeywordsLeadership, Conceptualization, Measurement, Evidence-based practice, Systematic review 2 BackgroundDespite widespread acceptance of the importance of implementing evidence-based practice (EBP) and the use of findings from scientific research in clinical practice, many patients still do not receive treatments with proven effectiveness or may receive care that is of little benefit or harmful (Dopson et al., 2002, Greenhalgh et al., 2004, Oxman et al., 1995. Implementation science has emerged as a vital interdisciplinary research field to address the challenges associated with the gap identified between the production and use of evidence in various settings. Explanations for this gap have largely focused on the characteristics of the individual provider, such as limited access to research, poor confidence in identifying and critically appraising evidence and perceived time restrictions to integrate research into clinical practice (Rycroft-Malone, 2008, Estabrooks et al., 2003, Squires et al., 2011.However, within the field of implementation science, there has been increasing recognition of the role of the organizational context in the implementation of EBP (Durlak and DuPre, 2008, Greenhalgh et al.,...

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Learning Challenges Associated with Evidence-Based Practice in Rheumatology

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