From Workshop to Work Practice: An Exploration of Context and Facilitation in the Development of Evidence‐Based Practice

Abstract

The contexts in each of the participating hospitals were very different; of the six hospitals, only one had not implemented the new protocol. Five had reviewed their practices and brought them in line with the protocol developed at the workshop. The rate of adoption varied considerably from 2 weeks to months. The participants reported being better informed about EBP in general and were positive about their ability to improve their practice and search more efficiently for best practice information. Underlying motivations for protocol development should be included in the PARIHS framework. IMPLICATIONS FOR EDUCATION: Good facilitation appears to be more influential than context in overcoming the barriers to the uptake of EBP.

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals

“…Staff in small hospitals often lack time and skills to evaluate the evidence base of the intervention by themselves (Ellis et al, 2005;Milner, Estabrooks, & Myrick, 2005;Rycroft-Malone et al, 2004). Our findings strongly indicate that, in hospitals with a less supportive evidence base, good facilitation can help overcome weak organizational resources for establishing evidence.…”

“…The importance of facilitation in implementation has been supported by previous research (Ellis et al, 2005;Harvey et al, 2002;Kitson et al, 1998;Rycroft-Malone et al, 2004;Sharp et al, 2004). In the PARIHS model, facilitation is placed on a continuum from being taskoriented to being holistic.…”

“…In two case studies, Rycroft-Malone et al (2004) found support for all three PARIHS components. Two studies examining nursing utilization of research found that both context and facilitation played a role in promoting implementation (Cummings, Estabrooks, Midodzi, Wallin, & Hayduk, 2007; as did a study of implementing evidence-based practice (Ellis, Howard, Larson, & Robertson, 2005). Sharp et al (2004), in their study of six Veterans Health Administration medical centers, found that context was the strongest component predicting successful implementation.…”

Educational Strategies to Promote Use of Evidence-Based Practices

“…See the article by Stebral and colleagues in this issue. The Internship was also a first of its kind, and the model has been used to build other programs [61][62][63].…”

EBP: Evidence to Practice Implementation

“…Developed specifically for health care in 1998 as a result of work with clinicians to improve practice, it has been used as a guide for structuring implementation projects at the point of care. [18][19][20] This framework proposes that the likelihood of the implementation of a change being successful depends on the relationship between the nature and strength of the evidence, the contextual factors of the setting, and the method of facilitation used to introduce the change. A strong point of this model is the ability to adapt the facilitation process to the level of evidence and the level of context support available, making it adaptable to various situations.…”