Grol R, Grimshaw J, et al.
Lancet (London, England). Date of publication 2003 Oct 11;volume 362(9391):1225-30.
1. Lancet. 2003 Oct 11;362(9391):1225-30. doi: 10.1016/S0140-6736(03)14546-1.
From best evidence to best practice: effective implementation of change in
patients' care.
Grol R(1), Grimshaw J.
Author information:
(1)Centre for Quality of Care Research (WOK), Universities of Nijmegen and
Maastricht, PO Box 9101, WOK 229 6500 HB, Nijmegen, Netherlands.
r.grol@wok.umcn.nl
Comment in
Lancet. 2003 Oct 11;362(9391):1170. doi: 10.1016/S0140-6736(03)14556-4.
Major difficulties arise when introducing evidence and clinical guidelines into
routine daily practice. Data show that many patients do not receive appropriate
care, or receive unnecessary or harmful care. Many approaches claim to offer
solutions to this problem; which ones are as yet the most effective and
efficient is unclear. We aim to provide an overview of present knowledge about
initiatives to changing medical practice. Substantial evidence suggests that to
change behaviour is possible, but this change generally requires comprehensive
approaches at different levels (doctor, team practice, hospital, wider
environment), tailored to specific settings and target groups. Plans for change
should be based on characteristics of the evidence or guideline itself and
barriers and facilitators to change. In general, evidence shows that none of the
approaches for transferring evidence to practice is superior to all changes in
all situations.
DOI: 10.1016/S0140-6736(03)14546-1
PMID: 14568747 [Indexed for MEDLINE]
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