Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK.
Int J Evid Based Healthc. 2019 Jun;17 Suppl 1:S18-S21. doi: 10.1097/XEB.0000000000000195.
Health services across the world are constantly introducing changes into their workplaces and these affect many people. As new robust and reliable evidence becomes available, it is important that changes to practice are made. As health professionals, we have to be flexible and accommodate this change; for some this means disruption, challenge and having to learn new ways of doing things. Barriers exist that prevent or delay changes being made to established practice in all organizations, whatever the culture. This is a world-wide problem. It is important to understand the barriers to change so that solutions can be found. Some changes that are needed don't occur, because clinicians are unaware of the new evidence, while for others there needs to be something introduced to drive forward the change. This process is not a passive one; active involvement is needed for the change to be successful. Individual attitudes and beliefs play a significant part in change, and their influences are often underestimated, so these also need to be explored. Practice change may require new skills to be learnt - another obstacle for change.
In this short communication, the science behind evidence implementation is introduced and then some of the factors that impact on change are explored, drawing on three useful models and frameworks.
Ultimately there remains a gap between interventions that research has shown to be effective and their translation into practice; this has to be closed.
世界各地的卫生服务机构一直在其工作场所进行变革，这些变革影响了许多人。随着新的有力且可靠的证据的出现，必须对实践进行变革。作为卫生专业人员，我们必须灵活并适应这种变化；对某些人来说，这意味着中断、挑战和必须学习新的做事方式。无论文化如何，在所有组织中，都存在阻碍或延迟既定实践变革的障碍。这是一个全球性问题。了解变革的障碍很重要，以便找到解决方案。一些需要的变革没有发生，因为临床医生不知道新的证据，而对于其他变革，则需要引入一些东西来推动变革。这个过程不是被动的；变革需要积极参与。个人态度和信念在变革中起着重要作用，其影响往往被低估，因此也需要加以探讨。实践变革可能需要学习新的技能——这是变革的另一个障碍。
在这篇简短的交流中，引入了证据实施背后的科学原理，然后探讨了一些影响变革的因素，借鉴了三个有用的模型和框架。
最终，研究表明有效的干预措施与其在实践中的转化之间仍然存在差距；必须弥合这一差距。
