Strategies to implement evidence into practice to improve palliative care: recommendations of a nominal group approach with expert opinion leaders.

Jasper Van Riet Paap,Marianne J Hjermstad,Kris Vissers,Rabih Chattat,Yvonne Engels,Myrra Vernooij-Dassen,Steve Iliffe,Lukas Radbruch

doi:10.1186/s12904-015-0044-9

Abstract

BackgroundIn 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.MethodsA 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.ResultsTwenty 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.DiscussionThe 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.

Highlights

In the past decades, many new insights and best practices in palliative care, a relatively new field in health care, have been published
A growing numbers of new insights and best practices in palliative care are being disseminated via scientific publications and presentations, yet they are often not implemented in daily practice [2]
This study identified specific strategies to implement the results of research projects in the field of palliative care

Summary

Introduction

Many new insights and best practices in palliative care, a relatively new field in health care, have been published. Chalmers et al state that about 85 % of the global annual investment in biomedical research is currently wasted, [6] even though effective strategies and models for stepwise implementation of new evidence exist. Examples of such strategies and models include the UK Medical Research Council’s framework for the development and evaluation of complex interventions to improve health, [7] the Plan-Do-Study-Act cycle, [8] or the van Riet Paap et al BMC Palliative Care (2015) 14:47 stepwise implementation model of Grol et al [2]. It is a challenge to continue implementation of new evidence and best practices in daily clinical practice after the research or implementation project has been completed, and it is not always seen as the role of researchers [4]

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Discussion

Conclusion