What drives change? Barriers to and incentives for achieving evidence-based practice

被引:915
作者
Grol, R [1 ]
Wensing, M [1 ]
机构
[1] Ctr Qual Care Res WOK, NL-6500 HB Nijmegen, Netherlands
关键词
D O I
10.5694/j.1326-5377.2004.tb05948.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To bridge the gap between scientific evidence and patient care we need an in-depth understanding of the barriers and incentives to achieving change in practice. Various theories and models for change point to a multitude of factors that may affect the successful implementation of evidence. However, the evidence for their value in the field is still limited. When planning complex changes in practice, potential barriers at various levels need to be addressed. Planning needs to take into account the nature of the innovation; characteristics of the professionals and patients involved; and the social, organisational, economic and political context.
引用
收藏
页码:S57 / S60
页数:4
相关论文
共 18 条
  • [1] [Anonymous], 2001, Evidence-based practice in primary care
  • [2] [Anonymous], 1962, DIFFUSION INNOVATION
  • [3] Baker R, 2001, BRIT J GEN PRACT, V51, P737
  • [4] Why don't physicians follow clinical practice guidelines? A framewouk for improvement
    Cabana, MD
    Rand, CS
    Powe, NR
    Wu, AW
    Wilson, MH
    Abboud, PAC
    Rubin, HR
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (15): : 1458 - 1465
  • [5] The case for knowledge translation: shortening the journey from evidence to effect
    Davis, D
    Evans, M
    Jadad, A
    Perrier, L
    Rath, D
    Ryan, D
    Sibbald, G
    Straus, S
    Rappolt, S
    Wowk, M
    Zwarenstein, M
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2003, 327 (7405): : 33 - 35
  • [6] DAVIS DA, 1995, JAMA-J AM MED ASSOC, V274, P700
  • [7] Perceived barriers to the implementation of diabetes guidelines in hospitals in The Netherlands
    Dijkstra, RF
    Braspenning, JCC
    Uiters, E
    van Ballegooie, E
    Grol, RTPM
    [J]. NETHERLANDS JOURNAL OF MEDICINE, 2000, 56 (03) : 80 - 85
  • [8] Process evaluation of a cluster randomized trial of tailored interventions to implement guidelines in primary care -: why is it so hard to change practice?
    Flottorp, S
    Håvelsrud, K
    Oxman, AD
    [J]. FAMILY PRACTICE, 2003, 20 (03) : 333 - 339
  • [9] GREEN L W, 1988, American Journal of Preventive Medicine, V4, P101
  • [10] Green L.W., 1991, HLTH PROMOTION PLANN