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J Health Serv Res Policy. 2001 Jan;6(1):23-31.

Implementation of evidence-based medicine: evaluation of the Promoting Action on Clinical Effectiveness programme.

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1
Templeton College, UK.

Abstract

OBJECTIVES:

To evaluate the Promoting Action on Clinical Effectiveness (PACE) programme, which sought to implement clinically effective practice in 16 local sites.

METHODS:

182 semi-structured interviews, usually by telephone, with project team members, clinicians, and senior managers and representatives from the Department of Health and the King's Fund.

RESULTS:

The most influential factors were strong evidence, supportive opinion leaders and integration within a committed organization; without these factors, projects had little chance of success. Other factors (context analysis, professional involvement and good project management) emerged as important, supporting processes; their presence might be an additional help, but on their own they would not be enough to initiate change. A serious problem with any of them could have a strong adverse impact.

CONCLUSIONS:

Although there is no simple formula for the factors that ensure successful implementation of research-based improvements to clinical practice, certain principles do seem to help. Time and resource need to be devoted to a period of local negotiation and adaptation of good research evidence based on a careful understanding of the local context, in which opinion leader influence is an important component of a well managed and preferably well integrated process of change.

PMID:
11219356
DOI:
10.1258/1355819011927161
[Indexed for MEDLINE]
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