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Is evidence-based implementation of evidence-based care possible?

Jeremy M Grimshaw and Martin P Eccles
Med J Aust 2004; 180 (6 Suppl): S50.

Summary

  • Traditional approaches to disseminating research findings have failed to achieve optimal healthcare.

  • In a systematic review of 235 studies of guideline dissemination and implementation strategies, we observed the following:

    • there was a median 10% improvement across studies, suggesting that it is possible to change healthcare provider behaviour and improve quality of care;

    • most dissemination and implementation strategies resulted in small to moderate improvements in care;

    • multifaceted interventions did not appear more effective than single interventions.

  • The interpretation of our systematic review is hindered by the lack of a robust theoretical base for understanding healthcare provider and organisational behaviour.

  • Future research is required to develop a better theoretical base and to evaluate further guideline dissemination and implementation strategies.

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  • Jeremy M Grimshaw1
  • Martin P Eccles2

  • 1 Clinical Epidemiology Programme, Ottawa Health Research Institute, Ottawa, ON, Canada.
  • 2 Centre for Health Services Research, School of Population and Health Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.

Correspondence: 

Acknowledgements: 

Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake funded by the Canadian Foundation for Innovation.

Competing interests:

The authors received honoraria from the National Institute of Clinical Studies for participation in the workshop “Development of strategies to encourage adoption of best evidence into practice in Australia”.

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