Research in clinical practice is often suggested as a mechanism to enhance transparency in decision- making, to overcome unwanted variation and to improve patient and system outcomes. However, most research-based knowledge fails to translate into practice. The result is that patients do not benefit optimally from research and are therefore exposed to unnecessary risks.
There are a lot of reasons why these evidence-practice gaps occur; one is that researchers rarely cooperate with the practitioners. Researchers and practitioners speak different languages. Many practitioners do not have the knowledge, skills or time to implement the evidence-based research.
Many programs and clinical guidelines are designed in optimal circumstances and not in the complex everyday life of clinical practice. This factor especially applies to elderly medical patients.
We work with the Knowledge To Action (KTO) model. KTO is a theoretic model developed to support the ‘black box’ call knowledge translation or implementation. The model contains two phases - a Knowledge creation phase and an Action cycle phase. The core principle of this model is continuous exchange of information between the two phases.
- To generate knowledge about implementation of clinical guidelines and evidence-based programs, for elderly medical patients.
- How to incorporate knowledge about the organisation’s local culture and learning processes, during implementation of clinical guidelines and evidence based health care programs.
- How to incorporate implementation science when designing evidence-based studies.
Action - Implementation of screening and brief intervention. This project is a health promoting mixed-methods implementation research project that examines the conditions for - and the implementation of an alcohol screening and brief intervention (SBI) adapted to the local context to optimize care and treatment for patients with alcohol problems. The project consists of three studies: 1) Explorative ethnographic studies consisting of field observations and interviews in two different emergency departments, 2) Tailoring of the intervention and implementation strategies and 3) the tailored version is fidelity tested to ensure successful implementation and sustainability. Project leader: Ditte Maria Sivertsen.
WALK-Cph. WALK-Cph is an implementation project aiming at investigating to what extend a patient intervention (WALK-Cph, aimed at increasing 24-hour activity in older medical patients) is implemented as planned. We will investigate which factors influence implementation both on an individual, a collective and an organizational level. This is done via implementation outcomes: implementations strategies, fidelity and adoption. The project consists of three studies: 1) Selection of implementation strategies, 2) fidelity of intervention and implementation strategies, 3) Evaluation of the implementation process. The project is based on qualitative methods such as work shops, observations and interviews. The project is inspired by various theories and "rammeværktøjer", e.g. Quality Implementation Framework, Theoretical Domain Framework and cultural theory. Project leaders: Jeanette Wassar Kirk and Mette Merete Pedersen.