Theory into practice: Applying the evidence across the health service
Changing the culture means creating organizations in which using research evidence to support the development and evaluation of services becomes second nature. Experience to date has indicated the need to integrate the promotion of clinical effectiveness into the mainstream activities of hospitals, health authorities and primary care organizations. It is important to use all available mechanisms for encouraging involvement and promoting change, including professional education, clinical audit, organizational and financial systems and information for patients. Successful implementation depends on developing a shared vision of the task to be accomplished, strong clinical leadership and a committed management team, time and resources to sustain the project, clarity about the scale of change required, a suitable plan and timetable, use of routine information systems to monitor progress and good communications between all those involved. The task of translating research findings into practice is not nearly as straightforward as has been commonly assumed, but it should be a priority for all those concerned about the quality of health care. The effectiveness and efficiency of health services could be substantially improved if evidence-based practice became the norm rather than the exception.