Strategies to implement evidence-informed practice at organizations: A rapid systematic review

Abstract

Abstract Background Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. Evidence-informed practice (EIP) involves implementing a specific practice or program with proven effectiveness. This rapid systematic review examines strategies for the implementation of EIDM and EIPs across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. Methods A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to shift teams, departments, or organizations to EIDM or EIP were eligible for inclusion. For each article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted from each included article. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. Results Fifty-nine articles are included. Studies were conducted in primary care, public health, social services, occupational health, and palliative care settings. Strategies to implement EIDM and EIP included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. Conclusion This review provides a comprehensive, in-depth analysis of facilitators and barriers for the implementation of EIDM and EIP in public health and related organizations, mapped to the COM-B model for behaviour change. The facilitators and barriers described in the included studies establish key factors for realizing greater implementation success in the future. Registration PROSPERO CRD42022318994