Janice Posatery Burke, Laura N. Gitlin; How Do We Change Practice When We Have the Evidence?. Am J Occup Ther 2012;66(5):e85-e88. doi: 10.5014/ajot.2012.004432.
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© 2017 American Occupational Therapy Association
Translating research findings into practice includes myriad pragmatic realities, including understanding the suitability of the data to a particular patient group, writing new guidelines for occupational therapy practitioners, facilitating adoption of the guidelines, and instituting new patterns of care for patients. The process is more than a matter of disseminating the information to practitioners and expecting immediate change in patient treatment. Indeed, the field of implementation science is devoted to the identification of the numerous barriers and supports that constrain or expedite practice change in response to research. Moving forward and adopting evidence-based findings will require a focused understanding of the particular setting where change is warranted. Among the issues to address are the health system levels involved in change (professional, legislative, administrative, practitioner, and patient and family members), the values and beliefs of the participants, and knowledge of the communication channels that exist in the setting and how information and new ideas make their way through the setting.
We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society’s occupational needs. (American Occupational Therapy Association [AOTA], 2007, p. 613)
a shift away from the traditional notion that getting evidence into practice is straightforward. Until relatively recently the spread of evidence was seen as a linear and technical process at the level of the individual, and was described as changes in clinicians’ behavior in line with evidence-based guidelines. Now there is widespread recognition that . . . implementation . . . requires whole system change. (p. 2)
Invite faculty from your local occupational therapy academic program to your clinic and initiate discussions about the patient assessment and treatment problems that are of high interest in your clinic.
Talk about ways you can contribute to the efforts of students as they select evidence-based topics that would be of mutual interest.
Engage clinicians, administrators, staff, and patients in discussions about what they would like to know more about and focus on as institution “brands.”
Complete thorough analyses of the culture and values of the settings, recognize the important stakeholders and decision makers, and approach them to discuss your staff’s interest in implementing evidence in the offerings of the clinic.
Understand your position in the system, enlist support, deconstruct obstacles, and carefully manage concerns and resources that are influencing your outcomes. These steps will contribute to the direction of the project you are about to undertake.
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