NHS临床指南 Getting Guidelines into Practice Lessons Learned from ResearchPPT.ppt

Factors Associated with Spread: Logistic Regression Analysis Spread from a unit/team within an organization was dependent on the success of the implementation strategies For every 1 unit ↑ in success of implementation you are 2.0 times as likely to have a BPG spread beyond a unit or team Spread outside the organization was dependent on the extent of change in team unit practices For every 1 unit ↑ in extent of change you are 6.8 times as likely to have a BPG spread beyond the organization Discussion Champions hold multiple roles: facilitator, change agent, knowledge translator Champions are persuasive practice leaders, work with many disciplines Champions work through complex web of committees and working groups Champions are adaptors who tailor BPG implementation strategies to organizational context Implications Adequate and ongoing training to maximize potential of champions role and impact Broad range of knowledge and skills: knowledge transfer, policy development, research and evaluation, leadership, mentorship Future Research What criteria should be used to select champions? Are characteristics of champions associated with effectiveness? (e.g., position, credibility, experience) Examine power, span of control, authority of champions What organizational supports are required for success of champions’ role? What constitutes a ‘critical mass’ of champions? What is the impact of champions? Study 3: Spreading Innovation – The Best Routes to Best Practices Barbara Davies, Judith Ritchie and team What We Studied: Examined naturally occurring diffusion of guidelines - how practice guidelines spread within and between organizations under normal, everyday conditions. Phase 1: We created diagrams to map how innovations spread within and outside an organization, two years after implementation of an RNAO BPG. Phase 2: We then visited 2 sites 7-10 years after original introduction. Study: Determinants of the Sustained Use of Research (SURE) Investigators: Ba