Ingredients for change: revisiting a conceptual framework.
Finding ways to deliver care based on the best possible evidence remains an ongoing challenge. Further theoretical developments of a conceptual framework are presented which influence the uptake of evidence into practice. A concept analysis has been conducted on the key elements of the framework--evidence, context, and facilitation--leading to refinement of the framework. While these three essential elements remain key to the process of implementation, changes have been made to their constituent sub-elements, enabling the detail of the framework to be revised. The concept analysis has shown that the relationship between the elements and sub-elements and their relative importance need to be better understood when implementing evidence based practice. Increased understanding of these relationships would help staff to plan more effective change strategies. Anecdotal reports suggest that the framework has a good level of validity. It is planned to develop it into a practical tool to aid those involved in planning, implementing, and evaluating the impact of changes in health care.
Rycroft-Malone
J
J
RCN Institute, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK. joanne.rycroft-malone@rcn.org.uk
Kitson
A
A
Harvey
G
G
McCormack
B
B
Seers
K
K
Titchen
A
A
Estabrooks
C
C
D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D015279:Organizational Culture; D009936:Organizational Innovation; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D006113:United Kingdom