How to Implement Evidence-Based Healthcare (eBook)

Trisha Greenhalgh (Autor)

eBook Download: PDF

2017
John Wiley & Sons (Verlag)
9781119238515 (ISBN)

Infos

British Medical Association Book Award Winner - President's Award of the Year 2018
From the author of the bestselling introduction to evidence-based medicine, this brand new title makes sense of the complex and confusing landscape of implementation science, the role of research impact, and how to avoid research waste.
How to Implement Evidence-Based Healthcare clearly and succinctly demystifies the implementation process, and explains how to successfully apply evidence-based healthcare to practice in order to ensure safe and effective practice. Written in an engaging and practical style, it includes frameworks, tools and techniques for successful implementation and behavioural change, as well as in-depth coverage and analysis of key themes and topics with a focus on:

• Groups and teams 
• Organisations 
• Patients 
• Technology 
• Policy 
• Networks and systems 

How to Implement Evidence-Based Healthcare is essential reading for students, clinicians and researchers focused on evidence-based medicine and healthcare, implementation science, applied healthcare research, and those working in public health, public policy, and management.

Trisha Greenhalgh, Professor of Primary Care Health Sciences, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, UK.

Inhalt

Title Page 5
Copyright Page 6
Contents 7
Foreword 8
Acknowledgements 10
Chapter 1 Introduction 11
1.1 The story of this book 11
1.2 There is no tooth fairy … 13
1.3 Outline of this book 15
References 19
Chapter 2 Evidence 20
2.1 (Research) Evidence 20
2.2 Knowledge translation, knowledge transfer 22
2.3 Different worlds 24
2.4 Attributes of innovations 26
2.5 Ten tips for translating evidence 28
1. Shorten 28
2. Sharpen 29
3. Tailor 30
4. Narrativise 30
5. Visualise 31
6. Recruit key messengers 33
7. Mobilise the media 33
8. Blog 34
9. Tweet 35
10. Bundle 36
References 36
Chapter 3 People 39
3.1 Introduction 39
3.2 Theories of human behaviour – an eclectic selection 40
‘Fast’ and ‘slow’ thinking heuristics
The theory of planned behaviour (Ajzen and Fishbein) 44
Learning domains: knowledge, skills and attitudes (Bloom) 45
Adult learning theory (Kolb, Knowles) 46
Social learning theory and self?efficacy (Bandura) 47
Dynamic (‘stages of …’) change theories (Prochaska/Diclemente, Rogers, Grol) 48
3.3 ‘Why don’t clinicians follow guidelines?’ 50
Michie et al.’s taxonomy of behaviour change theories 50
Cabana et al.’s model of barriers to physician adherence to guidelines 51
Grol’s three-level model for guideline adherence 53
3.4 Interventions aimed at changing clinician behaviour 53
Interventions that prompt, reward, or feed back on behaviour 53
Interventions that seek to improve knowledge 56
Interventions that promote the use of heuristics 57
Interventions that promote adult (on?the?job) learning 58
Interventions that promote social influence 59
Sequential interventions tailored to the intended adopter’s stage of change 59
3.5 Ten tips for influencing how people behave 60
1. Don’t think of people as empty buckets or blank slates 60
2. Think fast – and slow 62
3. Know your cognitive biases 62
4. Challenge stock theories of behaviour change 62
5. Get familiar with the basics of learning theory 62
6. Think of behaviour change as occurring in stages … 62
7. … and also as influenced at different levels 63
8. Distinguish ‘factors’ (barriers, facilitators) from explanations 63
9. Understand the limitations of experimental trials of interventions to change behaviour 63
10. Build capacity 63
References 64
Chapter 4 Groups and teams 67
4.1 Introduction: no man (or woman) is an island 67
4.2 Leadership 70
4.3 Facilitation and team learning 75
4.4 Empirical studies of leadership and facilitation 77
4.5 Ten tips for leading and facilitating teams 82
1. Understand the mathematics of group work 82
2. Attend to the team’s physical and material needs 82
3. Assess the context in which you will be working, and the implications for the preferred leadership style 82
4. Don’t be a wuss 82
5. Select your team carefully, and justify to everyone why people have been included 82
6. Clarify the task objectives and measures of success with your team 83
7. When facilitating a team, take account of task(s), context and team preparedness 83
8. Attend to people issues as well as task issues 83
9. Give plenty of feedback (both ‘hard’ and ‘soft’) 83
10. Attend to the cycle of team learning (single?, double? and triple?loop) 84
References 84
Chapter 5 Organisations 86
5.1 The diffusion of innovations model 86
5.2 Structural determinants of organisational innovativeness 90
5.3 Absorptive capacity and receptive context 91
5.4 Organisational readiness and the assimilation decision 96
Tension for change 96
Innovation–system fit 96
Assessment of implications 96
Support and advocacy 96
Dedicated time and resources 97
Capacity to evaluate the innovation 97
5.5 Implementation: balancing ‘hard’ and ‘soft’ efforts 98
SMART objectives 98
Staff involvement and commitment 98
Human resources 98
Tools and techniques 98
Intra-organisational networks 98
Extra-organisational networks 99
5.6 Routinisation and sustainability 100
5.7 Ten tips for promoting organisational innovation 103
To build your organisation’s general capacity to innovate 103
To support the introduction of a specific innovation 105
References 107
Chapter 6 Citizens 109
6.1 Citizens, the public, lay people – who are they (we)? 109
6.2 Lay involvement in research: how much and on whose terms? 112
6.3 ‘We ask the questions’: moving beyond a  researcher?focused EBHC 116
6.4 Conducting research with (as opposed to on) patients 118
6.5 Communicating research: whose literacy is the problem? 121
6.6 Ten tips for improving citizen involvement in research 123
1. Persuade yourself that citizen involvement matters 123
2. Use the right terminology 123
3. Understand what excellent looks like 123
4. Prioritise research questions that patients themselves pose 124
5. Conduct research with, not on, patients 124
6. Go further: co-create research 124
7. Learn to write (and speak) in plain English 124
8. Involve patients, citizens and the lay media in disseminating research findings 124
9. Get out more 125
10. Invite the public in 125
References 125
Chapter 7 Patients 128
7.1 Is the EBHC movement biased against patients? 128
7.2 Implementing evidence with patients in the clinical encounter 130
7.3 Self-management and how to support it 135
7.4 Patient involvement in service improvement 140
7.5 Ten tips for improving evidence?based patient care 142
Clinical care 142
Service improvement 143
Research 144
References 145
Chapter 8 Technology 148
8.1 The myth of technological determinism 148
8.2 Apps to support evidence?based (self?)management? 150
8.3 Why do patients resist technologies? 155
8.4 Why do clinicians resist technologies? 158
8.5 Ten tips for using technologies to support EBHC 163
1. Get real about where you lie on the geek spectrum 163
2. Move beyond technological determinism 164
3. Stop and think before designing an app 164
4. Learn more about how patients live with illness 165
5. Take randomised trials of technology?on versus technology?off with a pinch of salt 165
6. Read more about design 165
7. Study tasks and processes in organisations 166
8. Take a course in ethnography 166
9. Learn, and apply, the principles of sociotechnical design in organisations 166
10. If you want technology?supported change, resource it 166
References 167
Chapter 9 Policy 171
9.1 Evidence-based policy: beyond ‘barriers and facilitators’ 171
9.2 How does policymaking actually happen? 174
9.3 Value-based healthcare – and how values shape evidence 179
9.4 Ten tips for closer alignment between research and policy 185
1. Recognise the wide range of evidence that gets used by policymakers 185
2. Get your head round why most research is not useful to policymakers 186
3. Learn and apply some health economics 186
4. Consider the four ways in which research evidence is actually used by policymakers 186
5. Build relationships with policymakers 187
6. Produce policy-relevant summaries of evidence 187
7. Be aware of the power of framing – and develop frame awareness 187
8. Value data – but remember that all data are value?laden 188
9. Work actively to bridge the ‘two cultures’ divide 188
10. Seek to influence research policy 188
References 189
Chapter 10 Networks 192
10.1 Networks and knowledge 192
10.2 Social network analysis 194
10.3 Professional communities of practice and ‘mindlines’ 200
10.4 Patient communities and the work of living with illness 204
10.5 Ten tips for improving networks and networking 207
1. Extend your definition of what knowledge is 207
2. Revisit the section on how policymakers use evidence 207
3. Know your social influencers 207
4. Note the important principle of homophily 207
5. Acknowledge social influence as a social process, not an experimental variable 208
6. Harness the strength of weak ties for spreading ideas 208
7. Support professional communities of practice 208
8. Value mindlines 208
9. Support patient/carer communities 208
10. Learn from patient/carer communities 209
References 209
Chapter 11 Systems 213
11.1 Complex (adaptive) systems 213
11.2 Realist evaluation and review 219
11.3 Actor-networks 225
11.4 Multi-stakeholder health research systems 228
11.5 Ten tips for working with complex systems 234
1. Loosen up 234
2. Identify simple rules that drive actors 235
3. Consider embeddedness 235
4. When introducing order, look for disorder 235
5. Abandon the quest for a transferable ‘effect size’ 235
6. Ask, ‘What works for whom in what circumstances?’ 235
7. Map the actors in the network 235
8. Identify boundary objects 236
9. Understand the organisational actors in the multi?stakeholder research system 236
10. Consider how to co?create value for each disparate stakeholder 236
References 236
Appendix A Frameworks, tools and techniques 241
Appendix B Psychological domains and constructs relevant to the implementation of EBHC 267
Index 271
EULA 280

Produkt-Details

• Erscheint lt. Verlag: 23.5.2017
• Reihe/Serie: HOW - How To
• Reihe/Serie: HOW - How To
• Reihe/Serie: How To
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Gesundheitswesen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Schlagworte: Evidence-based healthcare • Evidence-based Health Care • evidence-based healthcare implementation networks • evidence-based healthcare implementation policies</p> • evidence-based healthcare implementation process • evidence-based healthcare implementation technology • evidence-based healthcare implementation tools and techniques • Evidenzbasierte Forschung im Gesundheitswesen • frameworks for healthcare implementation • Gesundheitswesen • Health Care • how to apply evidence-based healthcare • Implementation Science • <p>how to implement evidence-based healthcare • Medical Professional Development • Medical Science • Medical Statistics & Epidemiology • Medizin • Medizinische Statistik u. Epidemiologie • Perspektiven in medizinischen Berufen • what is implementation science
• ISBN-13: 9781119238515 / 9781119238515