The Library

Evaluating the successful implementation of evidence into practice using the PARiHS framework : theoretical and practical challenges

Tools

Kitson, Alison L., Rycroft-Malone, Jo, Harvey, Gill , McCormack, Brendan, Seers, Kate and Titchen, Angie. (2008) Evaluating the successful implementation of evidence into practice using the PARiHS framework : theoretical and practical challenges. Implementation Science, Vol.3 (No.1). ISSN 1748-5908

Preview

PDF
WRAP_Seers_Evaluating_successful.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (364Kb)

Official URL: http://dx.doi.org/10.1186/1748-5908-3-1

Abstract

Background The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified. Discussion This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally. Summary The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Social Sciences > School of Health and Social Studies
Library of Congress Subject Headings (LCSH):	Evidence based medicine, Medical care
Journal or Publication Title:	Implementation Science
Publisher:	BioMed Central Ltd.
ISSN:	1748-5908
Date:	7 January 2008
Volume:	Vol.3
Number:	No.1
Identification Number:	10.1186/1748-5908-3-1
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
References:	1. Grandos A, Jonsson E, Banta HD, Bero L, Bonari A, Cochet C, Freemantle N, Grilli R, Grimshaw J, Harvey E, Levi R, Marshall D, Oxman A, Pasart L, Raisanen V, Rius E, Espinas JA: EUR-ASSESS Project Subgroup Report on Dissemination and Impact. International Journal of Technology Assessment in Health Care 1997, 13(2):220-86. 2. Grimshaw J, Eccles M, Tetroe J: Implementing Clinical Guidelines: Current Evidence and Future Implications. Journal of Continuing Educ Health Prof 2004, 24:S31-S37. 3. Dopson S, Fitzgerald L, (Eds): Knowledge to Action? Evidence-based health care in context Oxford: Oxford University Press; 2005. 4. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence-based practice: a conceptual framework. Quality in Health Care 1998, 7(3):149-158. 5. Rycroft-Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Eastbrooks C: Ingredients for Change: Revisiting a conceptual model. Qual. Saf. Health Care 2002, 11:174-180. 6. Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, Seers K: Getting evidence into practice: The role and function of facilitation. Journal of Advanced Nursing 2002, 37(6):577-588. 7. McCormack B, Kitson A, Hervey G, Rycroft-Malone J, Titchen A, Seers K: Getting Evidence into Practice: The Meaning of Context. J. Adv. Nurs 2002, 38:94-104. 8. Rycroft-Malone J, Harvey G, Seers K, Kitson A, McCormack B, Titchen A: An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing 2004, 13:913-924. 9. Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B: What counts as evidence in evidence-based practice? Journal of Advanced Nursing 2004, 47(1):81-90. 10. Meijers JM, Janssen MAP, Cummings GG, Wallin L, Estabrooks CA, Halfens RYG: Assessing the relationships between contextual factors and research utilization in nursing: a systematic literature review. Journal of Advanced Nursing 2006, 55:622-635. 11. Wallin L, Estabrooks CA, Midodzi WK, Cummings GG: Development and validation of a derived measure of research utilization by nurses. Nursing Research 2006, 55(3):149-160. 12. Ellis I, Howard P, Larson A, Robertson J: From workshop to work practice: An exploration of context and facilitation in the development of evidence-based practice. Worldviews on Evidence- Based Nursing 2005, 2(2):84-93. 13. Brown D, McCormack B: Developing postoperative pain management: Utilising the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Worldviews on Evidence-Based Nursing 2005, 2(3):131-141. 14. Wright J, McCormack B, Coffey A, McCarthy G, Slater P: Evaluating the context within which continence care is provided in rehabilitation units for older people. International Journal of Older People Nursing 2007:1. 15. Graham ID, Logan J, Harrison MB, Straus S, Tetroe J, Caswell W, Robinson N: Lost in Translation: Time for a Map? The Journal of Continuing Education in the Health Professions 2006, 26(1):3-24. 16. Havelock RG: Planning for Innovation through Dissemination and Utilisation of Knowledge Ann Arbor, MI: Center for Research on Utilisation of Scientific Knowledge; 1969. 17. Rogers EM: Diffusion of Innovations 5th edition. New York: Free Press; 2003. 18. Greenhalgh T, Robert G, McFarlane F, Bate P, Kyriakidou O: Diffusion of Innovations in Service Organisations: Systematic Review and Recommendations. The Millbank Quarterly 2004, 82(4):581-629. 19. Tiffany C: Analysis of planned change theories. Nurse Manage 1994, 25:54-59. 20. Estabrooks CA, Thompson DS, Lovely JE, Hofmeyer A: A Guide to Knowledge Translation Theory. The Journal of Continuing Education in the Health Professions 2006, 26(1):25-36. 21. ICEBeRG Group: Designing theoretically-informed implementation interventions. Implementation Science 2006, 1:4: [http:// www.implementationscience.com/content/1/1/4]. 22. Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behaviour of healthcare professionals: the use of theory in promoting the uptake of research findings. Journal of Clinical Epidemiology 2005, 58:107-112. 23. Rycroft-Malone J: Theory and knowledge translation: Setting some co-ordinates? Nursing Research 56(4, S1):578-585. 24. Mittman BS, Tonesk X, Jacobson PD: Implementing clinical practice guidelines: Social influence strategies and practitioner behaviour change. QRB Qual Rev Bull 1992, 18:413-422. 25. Logan J, Harrison MB, Graham I, Dunn K, Bissonette J: Evidencebased pressure ulcer practice: The Ottawa Model of Research Use. Can J Nurs Res 1999, 31:37-52. 26. Stetler CB: Updating the Stetler Model of research utilisation to facilitate evidence-based practice. Nurs Outlook 2001, 49:272-279. 27. Titler MG, Kleiber C, Steelman VJ, et al.: The Iowa Model of Evidence Based Practice to promote quality care. Crit. Care Nurse Clin North Am 2001, 13:497-509. 28. Prochaska JO, Velicer WF: The transtheoretical model of health behaviour change. Am J Health Promot 1997, 12:38-48. 29. Sabatier PA: Theories of the Policy Process Colorado: Westview Press; 1999. 30. Ostrom E: An agenda for the study of Institutions. Public Choice 1986, 48:3-25. 31. Ostrom E: Institutional Rational Choice: An Assessment of the Institutional Analysis and Development Framework. In Theories of the Policy Process Edited by: Sabatier PA. Colorado: Westview Press; 1999. 32. Kuhn TS: The Structure of Scientific Revolutions Chicago: University of Chicago Press; 1970. 33. Pawson R, Greenhalgh T, Harvey G, Walshe K: Realist Review – a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy 2005, 10:1:21-34. 34. Stetler CB, Legro M, Rycroft-Malone J: The key role of "facilitation" in the implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration. Implementation Science 2006, 1:23: [http:/ /www.implementationscience.com/content/1/1/23]. 35. Milner M, Estabrooks CA, Myrisk F: Research utilization and clinical nurse educators: a systematic review. Journal of Evaluation in Clinical Practice 2006, 12(6):639-655. 36. Estabrooks CA, Wallin L, Milner M: Measuring knowledge utilization in health care. International Journal of Policy Evaluation & Management 2003, 1(1):3-36. 37. Rich RF: Measuring knowledge utilization processes and outcomes. Knowledge and Policy: International Journal of Knowledge Transfer and Utilization 1997, 3:11-24. 38. Oxman A: No Magic Bullets: A Systematic Review of 102 Trials of Interventions to help Care Professionals Deliver Services More Effectively and Efficiently. North East Thames Regional Health Authority. London 1994. 39. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thompson AT: Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. British Medical Journal 1998, 317:465-468. 40. Loftus-Hills A, Harvey G: A review of the role of the facilitator in changing professional healthcare practice RCN Institute. Oxford; 2000. 41. Royal College of Nursing: Becoming an RCN Accredited Facilitator Royal College of Nursing. London; 2004. 42. Titchen A, McGinley M: Facilitating practitioner-research through critical companionship. NTResearch 2003, 8(2):115-131. 43. McCormack B, Manley K, Garbett R: Practice Development in Nursing Oxford: Blackwell Publishing; 2004. 44. Titchen A, Manley K: Spiralling towards transformational action research: philosophical and practical journeys. Educational Action Research: an International Journal 2006, 14(3):333-356. 45. Van de Ven AH, Polley DE, Garud R, Venkataraman S: The Innovation Journey Oxford University Press Oxford; 1999. 46. Manley K, Hardy S, Titchen A, Garbett R, McCormack B: Changing Patients' Worlds through Nursing Practice Expertise: A Research Report London: Royal College of Nursing; 2005. 47. Van de Ven AH, Angle HL, Poole MS: Research on the Management of Innovation Oxford: Oxford University Press; 2000.
URI:	http://wrap.warwick.ac.uk/id/eprint/545