Institutionalizing Evidence-Based Practice: An Organizational Case Study Using a Model of Strategic Change

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dc.contributor.author Stetler, Cheryl B en_US
dc.contributor.author Ritchie, Judith A en_US
dc.contributor.author Rycroft-Malone, Jo en_US
dc.contributor.author Schultz, Alyce A en_US
dc.contributor.author Charns, Martin P en_US
dc.date.accessioned 2012-01-11T23:12:11Z
dc.date.available 2012-01-11T23:12:11Z
dc.date.copyright 2009 en_US
dc.date.issued 2009-11-30 en_US
dc.identifier.citation Stetler, Cheryl B, Judith A Ritchie, Jo Rycroft-Malone, Alyce A Schultz, Martin P Charns. "Institutionalizing evidence-based practice: an organizational case study using a model of strategic change" Implementation Science 4:78. (2009) en_US
dc.identifier.issn 1748-5908 en_US
dc.identifier.uri http://hdl.handle.net/2144/3314
dc.description.abstract BACKGROUND. There is a general expectation within healthcare that organizations should use evidence-based practice (EBP) as an approach to improving the quality of care. However, challenges exist regarding how to make EBP a reality, particularly at an organizational level and as a routine, sustained aspect of professional practice. METHODS. A mixed method explanatory case study was conducted to study context; i.e., in terms of the presence or absence of multiple, inter-related contextual elements and associated strategic approaches required for integrated, routine use of EBP ('institutionalization'). The Pettigrew et al. Content, Context, and Process model was used as the theoretical framework. Two sites in the US were purposively sampled to provide contrasting cases: i.e., a 'role model' site, widely recognized as demonstrating capacity to successfully implement and sustain EBP to a greater degree than others; and a 'beginner' site, self-perceived as early in the journey towards institutionalization. RESULTS. The two sites were clearly different in terms of their organizational context, level of EBP activity, and degree of institutionalization. For example, the role model site had a pervasive, integrated presence of EBP versus a sporadic, isolated presence in the beginner site. Within the inner context of the role model site, there was also a combination of the Pettigrew and colleagues' receptive elements that, together, appeared to enhance its ability to effectively implement EBP-related change at multiple levels. In contrast, the beginner site, which had been involved for a few years in EBP-related efforts, had primarily non-receptive conditions in several contextual elements and a fairly low overall level of EBP receptivity. The beginner site thus appeared, at the time of data collection, to lack an integrated context to either support or facilitate the institutionalization of EBP. CONCLUSION. Our findings provide evidence of some of the key contextual elements that may require attention if institutionalization of EBP is to be realized. They also suggest the need for an integrated set of receptive contextual elements to achieve EBP institutionalization; and they further support the importance of specific interactions among these elements, including ways in which leadership affects other contextual elements positively or negatively. en_US
dc.description.sponsorship Robert Wood Johnson Foundation en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2009 Stetler et al; licensee BioMed Central Ltd. en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title Institutionalizing Evidence-Based Practice: An Organizational Case Study Using a Model of Strategic Change en_US
dc.type article en_US
dc.identifier.doi 10.1186/1748-5908-4-78 en_US
dc.identifier.pubmedid 19948064 en_US
dc.identifier.pmcid 2795741 en_US

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