title: Models, strategies, and tools. Theory in implementing evidence-based findings into health care practice.
abstract: This paper presents a case for careful consideration of theory in planning to implement evidence-based practices into clinical care. As described, theory should be tightly linked to strategic planning through careful choice or creation of an implementation framework. Strategies should be linked to specific interventions and/or intervention components to be implemented, and the choice of tools should match the interventions and overall strategy, linking back to the original theory and framework. The thesis advanced is that in most studies where there is an attempt to implement planned change in clinical processes, theory is used loosely. An example of linking theory to intervention design is presented from a Mental Health Quality Enhancement Research Initiative effort to increase appropriate use of antipsychotic medication among patients with schizophrenia in the Veterans Health Administration.
authors.affiliation: VA Puget Sound Health Care System and Department of Health Services, University of Washington, Seattle, WA 98108, USA. ann.sales@med.va.gov
authors.forename: Anne
authors.initials: A
authors.lastname: Sales
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Smith
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Curran
authors.forename: Laura
authors.initials: L
authors.lastname: Kochevar
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D008605:Mental Health Services / Q000592:standards; D009936:Organizational Innovation; D017064:Process Assessment, Health Care; D012559:Schizophrenia / Q000188:drug therapy; D013598:Systems Theory; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D014150:Antipsychotic Agents