Manchester Julianne, Gray-Miceli Deanna L, Metcalf Judith A, Paolini Charlotte A, Napier Anne H, Coogle Constance L, Owens Myra G
Case Western Reserve University, School of Medicine, United States.
Rutgers University, College of Nursing, P.O. Box 1536, Mount Laurel, NJ 08054, United States.
Eval Program Plann. 2014 Dec;47:82-90. doi: 10.1016/j.evalprogplan.2014.08.007. Epub 2014 Aug 23.
Evidence based practices (EBPs) in clinical settings interact with and adapt to host organizational characteristics. The contextual factors themselves, surrounding health professions' practices, also adapt as practices become sustained. The authors assert the need for better planning models toward these contextual factors, the influence of which undergird a well-documented science to practice gap in literature on EBPs. The mechanism for EBP planners to anticipate contextual effects as programs Unfreeze their host settings, create Movement, and become Refrozen (Lewin, 1951) is present in Lewin's 3-step change model. Planning for contextual change appears equally important as planning for the actual practice outcomes among providers and patients. Two case studies from a Geriatric Education Center network will illustrate the synthesis of Lewin's three steps with collaborative evaluation principles. The use of the model may become an important tool for continuing education evaluators or organizations beginning a journey toward EBP demonstration projects in clinical settings.
临床环境中的循证实践(EBPs)与所在组织的特征相互作用并适应这些特征。围绕卫生专业实践的背景因素本身也会随着实践的持续而发生变化。作者们认为需要针对这些背景因素制定更好的规划模型,这些因素的影响在文献中充分证明了循证实践在从科学到实践的过程中存在差距。循证实践规划者在项目解冻其所在环境、促成变革并实现再冻结(Lewin,1951)时预测背景影响的机制,体现在Lewin的三步变革模型中。针对背景变化进行规划与针对提供者和患者的实际实践结果进行规划同样重要。来自老年教育中心网络的两个案例研究将说明Lewin的三个步骤与协作评估原则的结合。该模型的应用可能会成为继续教育评估者或开始在临床环境中开展循证实践示范项目之旅的组织的重要工具。