Gaps between knowing and doing: Understanding and assessing the barriers to optimal health care

Abstract

The findings establish the evolution of research methodologies and emerging barriers to the translation of knowing to doing. While many studies are methodologically weak, there are indications that designs are becoming more aligned with the complexity of the health care environment. The review provides support for the need to examine multiple factors within the knowledge-to-action process.

Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

“…Uma extensa literatura, em vários países, tem tentado compreender quais os fatores que limitam a adesão dos médicos às diretrizes 16,17,18 , apontando barreiras organizacionais, de fatores relacionados a pacientes, ao processo de implementação da diretriz e suas características.…”

Anti-Psychotic Medication and the Pattern of Cardiovascular Risk Factors: A Population Based Study (The Ayrshire Diabetes Follow-Up Cohort (ADOC) Study)

“…Some of the possible barriers to screening in practice include uncertainty as to whether such physical health screening was the responsibility of the psychiatric team rather than a primary care clinician [20], a lack of confidence in the interpretation of abnormal screening results [21] and limited access to basic infrastructure such as IT equipment [22]. Other possible explanations for the relatively low level of screening is that clinicians may target patients for the assessment of metabolic side effects rather than routinely screen all patients prescribed antipsychotic medication.…”

Exploring experiences among adopters during the diffusion of a novel dance intervention in Sweden

“…Numerous so-called determinant frameworks have been developed to describe barriers and facilitators that influence the implementation and use of new practices (Nilsen, 2015). Most of these frameworks describe three types of determinants that influence implementation: perceived attributes of the practice (e.g., complexity and relative advantage in relation to the current practice); individual characteristics of the users of the new practice (e.g., attitudes, beliefs and motivation concerning the new practice); and contextual factors (e.g., organizational support and support from colleagues and time constraints) (Cochrane, Olson, Murray, Dupuis, Tooman, Hayes., 2007; Damschroder et al, 2009; Grol, Wensing, & Eccles, 2005; Rycroft-Malone & Bucknall., 2010). The frameworks also address various strategies that support implementation, ideally accounting for as many determinants as possible to achieve successful implementation of a new practice (Bauer et al, 2015).…”