title: Strategies to implement evidence into practice to improve palliative care: recommendations of a nominal group approach with expert opinion leaders.
abstract: BACKGROUND
  In the past decades, many new insights and best practices in palliative care, a relatively new field in health care, have been published. However, this knowledge is often not implemented. The aim of this study therefore was to identify strategies to implement improvement activities identified in a research project within daily palliative care practice.
  
  
  METHODS
  A nominal group technique was used with members of the IMPACT consortium, being international researchers and clinicians in cancer care, dementia care and palliative care. Participants identified and prioritized implementation strategies. Data was analyzed qualitatively using inductive coding.
  
  
  RESULTS
  Twenty international clinicians and researchers participated in one of two parallel nominal group sessions. The recommended strategies to implement results from a research project were grouped in five common themes: 1. Dissemination of results e.g. by publishing results tailored to relevant audiences, 2. Identification and dissemination of unique selling points, 3. education e.g. by developing e-learning tools and integrating scientific evidence into core curricula, 4. Stimulation of participation of stakeholders, and 5. consideration of consequences e.g. rewarding services for their implementation successes but not services that fail to implement quality improvement activities.
  
  
  CONCLUSIONS
  The added value of this nominal group study lies in the prioritisation by the experts of strategies to influence the implementation of quality improvement activities in palliative care. Efforts to ensure future use of scientific findings should be built into research projects in order to prevent waste of resources.
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Jasper.vanRietPaap@radboudumc.nl.
authors.forename: Jasper
authors.initials: J
authors.lastname: van Riet Paap
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Kris.Vissers@radboudumc.nl.
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK. s.iliffe@ucl.ac.uk.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: Department of Palliative Medicine, Universitätsklinikum Bonn, Sigmund-Freud-Street 25, 53127, Bonn, Germany. Lukas.Radbruch@malteser.org.|Department of Palliative Care, Malteser Hospital Bonn/Rhein-Sieg, Bonn, Germany. Lukas.Radbruch@malteser.org.
authors.forename: Lukas
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: Regional Centre for Excellence in Palliative Care Department of Oncology, Oslo University Hospital, P.O. Box 4956, Nydalen, 0424, Oslo, Norway. marianne.j.hjermstad@ntnu.no.|European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, N-7491, Trondheim, Norway. marianne.j.hjermstad@ntnu.no.
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.affiliation: Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127, Bologna, Italy. rabih.chattat@unibo.it.
authors.forename: Rabih
authors.initials: R
authors.lastname: Chattat
authors.affiliation: Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Myrra.Vernooij-Dassen@radboudumc.nl.|Kalorama Foundation, Nijmegen, The Netherlands. Myrra.Vernooij-Dassen@radboudumc.nl.
authors.forename: Myrra
authors.initials: M
authors.lastname: Vernooij-Dassen
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. Yvonne.Engels@radboudumc.nl.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
mesh_terms: D003695:Delivery of Health Care / Q000379:methods* / Q000592:standards; D055317:Evidence-Based Practice / Q000379:methods*; D006801:Humans; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D012106:Research