Mining the Management Literature for Insights into Implementing Evidence-Based Change in Healthcare

Abstract

Objective: We synthesized the management and health literatures for insights into implementing evidence-based change in healthcare drawn from industry-specific data. Because change principles based on evidence often fail to be translated into organizational practice or policy, we sought studies at the nexus of organizational change and knowledge translation. Methods: We reviewed five top management journals to identify an initial pool of 3,091 studies, which yielded a final sample of 100 studies. data were abstracted, verified by the original authors and revised before entry into a database. We employed a systematic narrative synthesis approach using words and text to distill data and explain relationships. We categorized studies by varying levels of relevance for knowledge translation as (1) primary, direct; (2) intermediate; and (3) secondary, indirect. We also identified recurring categories of change-related organizational factors. The current analysis examines these factors in studies of primary relevance to knowledge translation, which we also coded for intervention readiness to reflect how readily change can be implemented. Preliminary Results and Conclusions:Results centred on five change-related categories: Tailoring the Intervention message; Institutional Links/Social Networks; Training; quality of Work Relationships; and fit to Organization. In particular, networks across institutional and individual levels appeared as prominent pathways for changing healthcare organizations. Power dynamics, positive social relations and team structures also played key roles in implementing change and translating it into practice. We analyzed journals in which first authors of these studies typically publish, and found evidence that management and health sciences remain divided. Bridging these disciplines through research syntheses promises a wealth of evidence and insights, well worth mining in the search for change that works in healthcare transformation. RésuméObjectif : Nous avons effectué une synthèse de la littérature sur la gestion et sur la santé pour obtenir des pistes quant à la mise en oeuvre de changements fondés sur les données probantes dans les services de santé, et ce, à partir de données propres au secteur d' activité. Puisque la transposition des principes du changement fondé sur les données probantes dans la pratique ou politique organisationnelles est souvent vouée à l' échec, nous avons tenté de comprendre les liens entre le changement organisationnel et la transposition des connaissances. Méthodes : L' examen de cinq importantes revues de gestion nous a permis de repérer un bassin initial de 3 091 études, desquelles nous avons tiré un échantillon final de 100 études. Les données ont été résumées, vérifiées par leurs auteurs et révisées avant d' être versées dans une base de données. Nous avons employé une démarche de synthèse narrative systématique au moyen de mots et de texte afin de raffiner les données et d' expliquer les relations. Nous avons catégorisé les études en fonction de diffé...

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