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Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study

BACKGROUND: Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitat...

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Autores principales: Ellen, Moriah E, Léon, Grégory, Bouchard, Gisèle, Ouimet, Mathieu, Grimshaw, Jeremy M, Lavis, John N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4299810/
https://www.ncbi.nlm.nih.gov/pubmed/25476735
http://dx.doi.org/10.1186/s13012-014-0179-8
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author Ellen, Moriah E
Léon, Grégory
Bouchard, Gisèle
Ouimet, Mathieu
Grimshaw, Jeremy M
Lavis, John N
author_facet Ellen, Moriah E
Léon, Grégory
Bouchard, Gisèle
Ouimet, Mathieu
Grimshaw, Jeremy M
Lavis, John N
author_sort Ellen, Moriah E
collection PubMed
description BACKGROUND: Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. METHODS: This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. RESULTS: Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to implementing supports for EIDM. The most frequently cited views about emerging development of supports for EIDM were implementing accessible and efficient systems to support the use of research in decision-making (e.g., documentation and reporting tools, communication tools, and decision support tools) and developing and implementing an infrastructure or position where the accountability for encouraging knowledge use lies. The most frequently stated priorities for bridging the gaps in the current mix of supports that these organizations have in place were implementing technical infrastructures to support research use and to ensure access to research evidence and establishing formal or informal ties to researchers and knowledge brokers outside the organization who can assist in EIDM. CONCLUSIONS: These results provide insights on the type of practical implementation imperatives involved in supporting EIDM.
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spelling pubmed-42998102015-01-21 Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study Ellen, Moriah E Léon, Grégory Bouchard, Gisèle Ouimet, Mathieu Grimshaw, Jeremy M Lavis, John N Implement Sci Research BACKGROUND: Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. METHODS: This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. RESULTS: Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest from health system decision-makers, notably their willingness to invest money and resources and to create a knowledge translation culture over time in health-care organizations, was the most frequently identified facilitator to implementing supports for EIDM. The most frequently cited views about emerging development of supports for EIDM were implementing accessible and efficient systems to support the use of research in decision-making (e.g., documentation and reporting tools, communication tools, and decision support tools) and developing and implementing an infrastructure or position where the accountability for encouraging knowledge use lies. The most frequently stated priorities for bridging the gaps in the current mix of supports that these organizations have in place were implementing technical infrastructures to support research use and to ensure access to research evidence and establishing formal or informal ties to researchers and knowledge brokers outside the organization who can assist in EIDM. CONCLUSIONS: These results provide insights on the type of practical implementation imperatives involved in supporting EIDM. BioMed Central 2014-12-05 /pmc/articles/PMC4299810/ /pubmed/25476735 http://dx.doi.org/10.1186/s13012-014-0179-8 Text en © Ellen et al.; licensee BioMed Central. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ellen, Moriah E
Léon, Grégory
Bouchard, Gisèle
Ouimet, Mathieu
Grimshaw, Jeremy M
Lavis, John N
Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title_full Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title_fullStr Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title_full_unstemmed Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title_short Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
title_sort barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4299810/
https://www.ncbi.nlm.nih.gov/pubmed/25476735
http://dx.doi.org/10.1186/s13012-014-0179-8
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