“Inside Looking In” or “Inside Looking Out”? How Leaders Shape Cultures Equipped for Evidence-Based Practice

Halm, Margo A.

doi:10.4037/ajcc2010627

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…26 Although both transformational and transactional leadership can be associated with encouraging attitudes towards EBDM and staff trying new things, transformational leadership specifically makes staff more likely to find new practices appealing, more likely to adopt them, and more likely to perceive fewer gaps between EBDM and their current practices. 27 This may be particularly important for the differences observed between high- and low-capacity LHDs with regard to program adaptation, and the enthusiasm in high-capacity LHDs to adapt programs as opposed to the hesitancy to approach programs requiring adaptation among low-capacity LHDs. Leaders in low-capacity LHDs might seek to adopt this leadership style, which might build a positive attitude toward innovation among their staff.…”

Section: Discussionmentioning

confidence: 99%

“…Factors needed to facilitate a QI culture include having agency leaders and staff who are committed to using QI processes, aligning QI practices with strategic goals, having experience in QI or EBDM in the past, having leaders, partners, and boards that hold them accountable for their service quality, and having a supportive infrastructure with sufficient resources to maintain a QI culture. 27–29 For many high-capacity LHDs, program evaluation has involved creating a culture of improvement within their agency that makes it an expectation—if they do face barriers, most of the time it is in formalizing the process. While some of the challenges faced by low-capacity LHDs are not modifiable, it might be feasible to begin to shift the culture of the organization toward one more supportive of QI.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments

Tabak

Duggan

Smith

et al. 2016

Journal of Public Health Management and Practice

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Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high-capacity LHDs reported efforts to integrate evidence-based public health. Conclusions Investments in leadership support for improving organizational capacity, improvements in communication from the top of the organization, integrating program evaluation into implementation, and greater funding flexibility may enhance sustainability of evidence-based public health in LHDs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments

Tabak

Duggan

Smith

et al. 2016

Journal of Public Health Management and Practice

View full text Add to dashboard Cite

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“…Research utilization, a top interest of nearly 25% of USA nurse executives requires strong leadership committed to model and facilitate EBP (Advisory Board Company 2005). Commitment requires leaders to transform the culture through an inspired shared vision that clearly establishes EBP as integral component of patient care (Halm 2010).…”

Section: Introductionmentioning

confidence: 99%

Leadership facilitation strategies to establish evidence‐based practice in an acute care hospital

Hauck

Winsett

Kuric

2012

Journal of Advanced Nursing

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“…The role of strong leadership in creating a context which supports research implementation in healthcare has been described in the literature (e.g., Crow, 2006;Halm, 2010;Kitson et al, 1998;Marchionni & Ritchie, 2008;McCormack et al, 2002;Newhouse, 2007). In speech pathology, the role of leadership in creating evidence-based services is beginning to gain recognition and support.…”

Section: Attitudes Of Staff Inmentioning

confidence: 96%

Turning the tide: Putting acute aphasia management back on the agenda through evidence-based practice

Foster¹,

Worrall²,

Rose³

et al. 2013

Aphasiology

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Background: The role of speech pathologists working in the acute hospital setting has evolved away from service provision to people with aphasia and their families towards a stronger focus on dysphagia. Evidence-based practice (EBP) can be conceptualised as the integration of four streams of evidence: research-based clinical evidence, clinical expertise, patient preferences and values, and the practice context. EBP is an important tenet in current healthcare. However, it is not clear whether speech pathologists in the acute setting are using EBP to support their aphasia management. Not adopting evidence-based approaches to care has the potential to result in a negative impact on people with aphasia and their families, healthcare services, and speech pathologists, who experience a sense of dissonance related to their current service provision This paper explores acute aphasia management through an EBP lens in an attempt to better understand this dilemma. Aims: This paper applies the conceptual framework of EBP to acute aphasia management. An extensive, systematically conducted review of the international literature relating to health professionals was undertaken. The findings are presented as a narrative literature review. Main Contribution: This paper describes and evaluates how the different streams of research evidence, clinical expertise, patient preferences and values, and the practice context contribute to speech pathologists' management of acute aphasia. Further, the paper identifies current gaps in the literature and suggests a research agenda for the field. Conclusions: Little is known about how speech pathologists integrate and implement the different streams of evidence in EBP, and how these contribute to acute aphasia practice. Speech pathologists report that clinical guidelines containing low-level evidence are the main source of research information. Other sources of knowledge include colleagues, professional development events, and websites. Additional challenges to the management of people with aphasia in the acute hospital setting may be posed by the physical environment, the culture of the acute hospital setting, and the provision of leadership to support evidence-based approaches to care. The challenge of using a person-centred approach to care for people with aphasia is acknowledged. Further research exploring speech pathologists' perceptions of their role in acute aphasia management, the clinical decision-making process of speech pathologists in relation to acute aphasia management, and the experiences of people with aphasia and their families in the acute setting is required. This will

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“Inside Looking In” or “Inside Looking Out”? How Leaders Shape Cultures Equipped for Evidence-Based Practice

Cited by 8 publications

References 32 publications

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments

Leadership facilitation strategies to establish evidence‐based practice in an acute care hospital

Turning the tide: Putting acute aphasia management back on the agenda through evidence-based practice

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