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Cited by 4,531Health Policy Implementation ScienceClinical practice guidelines implementationHealth Sciences Research and Education

From best evidence to best practice: effective implementation of change in patients' care

Grol, Richard, Grimshaw, Jeremy·2003·The Lancet
DOI 10.1016/s0140-6736(03)14546-1
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Abstract

Major difficulties arise when introducing evidence and clinical guidelines into routine daily practice. Data show that many patients do not receive appropriate care, or receive unnecessary or harmful care. Many approaches claim to offer solutions to this problem; which ones are as yet the most effective and efficient is unclear. We aim to provide an overview of present knowledge about initiatives to changing medical practice. Substantial evidence suggests that to change behaviour is possible, but this change generally requires comprehensive approaches at different levels (doctor, team practice, hospital, wider environment), tailored to specific settings and target groups. Plans for change should be based on characteristics of the evidence or guideline itself and barriers and facilitators to change. In general, evidence shows that none of the approaches for transferring evidence to practice is superior to all changes in all situations.

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Crossref · 10.1016/s0140-6736(03)14546-1

Cites

96 of 96 references verified0 citation errors · 0 not checkable

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  • Similar findings on adherence have been reported across a number of clinical areas in different countries.

    “Similar findings have been reported across a number of clinical areas in different countries [4–6].”

    From Achieving change in primary care—causes of the evidence to practice gap: systematic reviews of reviews (2015) · cites this paper as [6]

  • Improving the adoption and implementation of evidence-based interventions into routine practice involves changes in healthcare professionals' behaviors that may be influenced by a range of individual, organizational, and social factors.

    “Improving the adoption and implementation of evidence-based interventions into routine practice involves changes in healthcare professionals’ behaviors that may be influenced by a range of individual, organizational, and social factors [16-20].”

    From Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research (2014) · cites this paper as [19]

  • The initial version of the questionnaire included items related to characteristics of the innovation, organization, socio-political context, and innovation strategies.

    “The initial version of the questionnaire included items related to characteristics of the innovation, organization, socio-political context, and innovation strategies [16-20]”

    From Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research (2014) · cites this paper as [19]

  • The TDF mainly focuses on factors related to the adopting person, instead of taking into account a variety of factors related to characteristics of the innovation, patient, social setting, organizational context, and innovation methods and strategies.

    “the TDF [37], however, mainly focuses on factors related to the adopting person, instead of taking into account a variety of factors related to characteristics of the innovation, patient, social setting, organizational context, and innovation methods and strategies [16-20]”

    From Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research (2014) · cites this paper as [19]

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Authors
Grol, R., & Grimshaw, J.
Affiliations
Radboud University Nijmegen (NL)
Corresponding author
Grol, Richard
ORCID
Grimshaw, Jeremy
Venue
The Lancet
Publisher
Elsevier BV
Published
2003-10
Volume
362
Issue
9391
Pages
1225-1230
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(03)14546-1
OpenAlex
W2143981995
Cited by
4,531
References
99
Citations by year
2026: 118 · 2025: 112 · 2024: 177 · 2023: 156 · 2022: 153 · 2021: 205 · 2020: 248 · 2019: 217 · 2018: 228 · 2017: 228 · 2016: 267 · 2015: 288 · 2014: 305 · 2013: 307 · 2012: 268
FWCI
22.33
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
evidence-based practice, clinical guidelines, change implementation, behavior change, barriers and facilitators, quality of care, inappropriate care, organizational change
MeSH terms
Patient Care, Humans, Professional Practice, Quality Assurance, Health Care, Quality of Health Care, Practice Guidelines as Topic, Evidence-Based Medicine, Guideline Adherence

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