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Med J Aust. 2004 Mar 15;180(S6):S50-1.

Is evidence-based implementation of evidence-based care possible?

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Clinical Epidemiology Programme, Ottawa Health Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.


Traditional approaches to disseminating research findings have failed to achieve optimal healthcare. In a systematic review of 235 studies of guideline dissemination and implementation strategies, we observed the following: there was a median 10% improvement across studies, suggesting that it is possible to change healthcare provider behaviour and improve quality of care; most dissemination and implementation strategies resulted in small to moderate improvements in care; multifaceted interventions did not appear more effective than single interventions. The interpretation of our systematic review is hindered by the lack of a robust theoretical base for understanding healthcare provider and organisational behaviour. Future research is required to develop a better theoretical base and to evaluate further guideline dissemination and implementation strategies.

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