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From best evidence to best practice: effective implementation of change in patients' care
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Metadata
- 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
- 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
- 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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