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

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

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