Translating Evidence Into Practice Through Knowledge Implementation

Abstract

It is well established that it can take upward of 20 years to implement research findings into clinical practice. Research findings do not always translate well into the clinical environment for a number of reasons including organizational/individual resistance to change, disruption in workflow, lack of intervention adaptability, and the complexity of patients in the rehabilitation setting. Physical therapists will benefit from an understanding of implementation science (IS) in order to optimize the integration of evidence-based practices (EBPs) into the clinical setting. Implementation science focuses on how interventions work in real settings, how to improve them, and how to sustain them. It provides a framework for identifying barriers and facilitators to the uptake of the desired behavior and engages stakeholders of multiple levels into the process. Two frameworks, the Knowledge-to-Action framework and the Consolidated Framework for Implementation Research, are presented to provide guidance to clinicians and researchers in oncology rehabilitation who are interested in embarking upon IS projects. A hybrid version of the 2 frameworks is proposed with the aim of providing stakeholders with stronger and targeted tools to increase the likelihood of successful implementation of EBP. The purpose of this perspective is to describe IS, key frameworks, and strategies of knowledge implementation and to identify barriers and facilitators to implementation of contemporary research into clinical practices. The secondary purpose of this article is to demonstrate its application for the Academy of Oncologic Physical Therapy.

IKT for Research Stage 4: Study Design

“…5 Make certain that data collection and analysis methods are feasible within local contexts, and accessible for participation by individuals outside of academia (Campione et al, 2021).…”

Narrowing the Evidence-to-Practice Gap

“…In a previous piece in the journal, Campione et al1 advocated for oncology researchers and practitioners to use implementation science strategies to move evidence into practice, arguing that the oft-cited 17 years that it takes to move evidence into practice are too long. Key steps to accomplish this are as follows: (1) identifying clinical problems; (2) determining best evidence to address the clinical problem; (3) surveying the clinical environment to identify and address barriers to change and facilitators to implement new strategies; and (4) evaluating the effectiveness of the changed practice.…”

IKT for Research Stage 2: Generating Priorities and Ideas

“…Together with partners, identify the desired outcomes and impact of the priority research topic(El- Jardali & Fadlallah, 2015).3 Apply participatory working principles (refer to Knowledge Brief 1) to: (i) facilitate communication and dialogue with stakeholders who have a vested interest in the priority research topic and (ii) promote consensus building among team members(Jull et al, 2017).4 Make use of IKT tools such as 'The Knowledge Funnel' to collaboratively distill and refine ideas to support the knowledge co-creation process(Graham et al, 2006).5 Establish what we already know and current gaps in knowledge by conducting a collaborative evidence review that involves co-designing the evidence strategy with all key stakeholders(Barwick et al, 2009;Gagnon, 2011).6 Findings from the collaborative evidence review can be used to inform the co-design of the research strategy(Campione et al, 2021).What is 'generating priorities and ideas' in relation to IKT in research?Stage 2 of IKT informed research is about 'generating priorities and ideas' with stakeholders who are invested in the research. Traditionally, research priorities and ideas have often been predetermined by academic researchers(Skipper & Pepler).…”