Attributes of context relevant to healthcare professionals’ use of research evidence in clinical practice: a multi-study analysis

Implementation Science

Alison M. Hutchinson¹  Laura D. Aloisio²  Kristin Dorrance²  Mary Coughlin²  Jeremy M. Grimshaw³  Jamie Brehaut⁴  Ian D. Graham⁴  Jill Francis⁵  Jocelyn Vine⁶  Kainat Bashir⁷  Janet E. Squires⁸  Noah Ivers⁹  Michael Hillmer^1,10  Thomas Noseworthy^1,11  Janet Curran^1,12  John Lavis^1,13  Anne Sales^1,14  Susan Michie^1,15 

[1] 0000 0000 9295 3933, grid.419789.a, Monash Health, Melbourne, Australia;0000 0001 0526 7079, grid.1021.2, Deakin University, Geelong, Australia;0000 0000 9606 5108, grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;0000 0000 9606 5108, grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;0000 0001 2182 2255, grid.28046.38, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada;0000 0000 9606 5108, grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;0000 0001 2182 2255, grid.28046.38, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada;0000 0000 9606 5108, grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;0000 0004 1936 8497, grid.28577.3f, City University of London, London, UK;0000 0001 0351 6983, grid.414870.e, IWK Health Centre, Halifax, NS, Canada;0000 0001 2157 2938, grid.17063.33, Institute of Health Policy, Management, Evaluation, University of Toronto, Toronto, Canada;0000 0001 2182 2255, grid.28046.38, Department of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada;0000 0000 9606 5108, grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;0000 0004 0474 0188, grid.417199.3, Women’s College Hospital, Toronto, ON, Canada;0000 0004 0500 0405, grid.415822.8, Ontario Ministry of Health and Long-term Care, Toronto, ON, Canada;0000 0004 1936 7697, grid.22072.35, University of Calgary, Calgary, AB, Canada;0000 0004 1936 8200, grid.55602.34, Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada;0000 0001 0351 6983, grid.414870.e, IWK Health Centre, Halifax, NS, Canada;0000 0004 1936 8227, grid.25073.33, McMaster University, Hamilton, ON, Canada;0000000086837370, grid.214458.e, University of Michigan, Ann Arbor, MI, USA;0000 0004 0419 7525, grid.413800.e, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA;0000000121901201, grid.83440.3b, University College London, London, UK;

关键词: Context;    Secondary analysis;    Evidence-based practice;   

DOI  :  10.1186/s13012-019-0900-8

来源: publisher

【 摘 要 】

BackgroundTo increase the likelihood of successful implementation of evidence-based practices, researchers, knowledge users, and healthcare professionals must consider aspects of context that promote and hinder implementation in their setting. The purpose of the current study was to identify contextual attributes and their features relevant to implementation by healthcare professionals and compare and contrast these attributes and features across different clinical settings and healthcare professional roles.MethodsWe conducted a secondary analysis of 145 semi-structured interviews comprising 11 studies (10 from Canada and one from Australia) investigating healthcare professionals’ perceived barriers and enablers to their use of research evidence in clinical practice. The data was collected using semi-structured interview guides informed by the Theoretical Domains Framework across different healthcare professional roles, settings, and practices. We analyzed these data inductively, using constant comparative analysis, to identify attributes of context and their features reported in the interviews. We compared these data by (1) setting (primary care, hospital-medical/surgical, hospital-emergency room, hospital-critical care) and (2) professional role (physicians and residents, nurses and organ donor coordinators).ResultsWe identified 62 unique features of context, which we categorized under 14 broader attributes of context. The 14 attributes were resource access, work structure, patient characteristics, professional role, culture, facility characteristics, system features, healthcare professional characteristics, financial, collaboration, leadership, evaluation, regulatory or legislative standards, and societal influences. We found instances of the majority (n = 12, 86%) of attributes of context across multiple (n = 6 or more) clinical behaviors. We also found little variation in the 14 attributes of context by setting (primary care and hospitals) and professional role (physicians and residents, and nurses and organ donor coordinators).ConclusionsThere was considerable consistency in the 14 attributes identified irrespective of the clinical behavior, setting, or professional role, supporting broad utility of the attributes of context identified in this study. There was more variation in the finer-grained features of these attributes with the most substantial variation being by setting.

【 授权许可】

CC BY