Translating Research Evidence Research Articles

Advancing evidence-based practice through the Knowledge Translation Challenge: Nurses' important roles in research, implementation science and practice change.

To describe a knowledge translation capacity-building initiative and illustrate the roles of nurses in practice change using an exemplar case study. The report uses observational methods and reflection. The Knowledge Translation Challenge program involves a multi-component intervention across several sites. The advisory committee invited eligible teams to attend capacity-building workshops. Implementation plans were developed, and successful teams receive funding for a 2 year period. Evaluation involved collecting data on program uptake and impact on practice change. Data has been collected from five cohorts. The exemplar case study employed an action-research framework. Four nurse-led teams have demonstrated successful implementation of their practice change. The case study on implementing a clinical toolkit for clozapine management further illustrates a thoughtful planning process, and implementation journey and learnings by a team of nurses. The Knowledge Translation Challenge program empowers nurses to use implementation science practices to enhance the quality and effectiveness of healthcare services. Success of this initiative serves as a model for addressing the persistent gap between knowledge and practice in clinical settings and the value of activating nurses to help close this gap. As the most trusted and numerous profession, it is vital that nurses contribute to efforts to translate research evidence into clinical practice. The Knowledge Translation Challenge program supports nurses to lead practice change. The Knowledge Translation Challenge program successfully equips nurses and other health care providers with the knowledge, skills and resources to implement practice improvements which enhance the quality and effectiveness of healthcare services and nursing practice. The Knowledge Translation Challenge advisory committee has three patient-public partners that support teams to develop a patient-oriented approach for their projects by providing feedback on the implementation plans. Each team was also supported to include patient-public partners on their project.

133 Research in Action: Engaging Clinicians to Advance the Academic Learning Health System

OBJECTIVES/GOALS: Research in Action is an on-demand, interactive curriculum designed to increase the ability of clinicians to advance the Academic Learning Health System (aLHS). The 7-module course provides clinicians with the knowledge and skills to lead rigorous quality improvement (QI) projects, translating research evidence into practice. METHODS/STUDY POPULATION: We engaged nurses, physicians, and advanced practice providers (APPs) working in the health system to participate in focus group and advise us in the creation of the curriculum. We conducted focus groups with these stakeholders on the proposed learning objectives, course content, and mode of delivery (in person, virtual, hybrid). Informed by the focus groups, the course was designed for hybrid format so participants could either (1) access the modules on-demand, or (2) learners could participate in a facilitator moderated course where the modules served as the curriculum to guide development of a QI project. The Iowa Model of Evidence-Based Practice was the framework for curriculum development. Upon completion of the modules, stakeholders reviewed each module and provided feedback for improvement. RESULTS/ANTICIPATED RESULTS: Research in Action is a 7-module course, with modules addressing the following topics: (1) Introduction to Quality Improvement, (2) Identify the Problem and Write a Purpose Statement, (3) Form a Team, (4) Appraise and Synthesize the Literature, (5) Design and Pilot the Project, (6) Integrate and Sustain Practice Change, (7) Disseminate the Results. The curriculum is being piloted with multiple clinician groups in the health system. In the next phase of development, a facilitator guide will be created to guide a cohort of clinicians to apply knowledge through discussion sessions and completion of a QI project in the healthcare setting. We anticipate scaling the program for spread to diverse clinician groups in the health system. Pre- and post-implementation data are being collected from current pilot sites. DISCUSSION/SIGNIFICANCE: The aLHS is an essential means for improving healthcare delivery. Research in Action, a hybrid training curriculum, engages frontline clinicians in creating and leading QI projects that implement research evidence into practice to solve problems commonly encountered in the healthcare setting; thus, supporting the advancement of the aLHS.

Partnering Research and Clinical Practice to Implement a Photon-Counting Detector CT Myocardial Perfusion Imaging Study

Implementation of research studies in clinical practice may encounter institutional, cultural, or resource barriers. Lack of nursing representation during the development of research protocols and decision-making, as well as financial constraints and competing priorities can impact translating research evidence into practice. At a large Midwestern teaching hospital, these barriers are addressed using professional nursing practice and a team-based approach to patient care and innovation, which in turn improves health outcomes for patients. The institution's commitment to nursing research in the radiology department aids in the implementation of innovative imaging technologies with the potential for improved detection and diagnosis of coronary artery disease. This article will outline radiology nursing involvement in the development of a dual-purpose research and clinical exam utilizing advanced computed tomography scanner technology. This article will also show how the institution works through common barriers to nursing research and how its efforts aid in the translation of evidence-based research into clinical practice.

Raising the issue of quality in implementation science reporting in global health: Implications for health planning and practice.

Implementation outcomes, which focus on the barriers to, and facilitators and processes of healthcare delivery, are critical to translating research evidence to health planning and practice and to improving healthcare delivery. This article summarises key quality issues in reporting of implementation science outcomes within global health and describes the ways in which this presents a challenge for shifting health planning and practice across low-resource health systems. This article also suggests that the wider use of reporting guidelines for implementation outcomes could help address this issue.

Drop-out, adherence, and compliance in randomized controlled trials of exercise training in multiple sclerosis: Short report

We documented reporting and rates of drop-out, adherence, and compliance from 40 randomized controlled trials (RCTs) included in our meta-analysis on safety of exercise training (ET) in MS. We adopted definitions and metrics of adherence and compliance provided by the MoXFo adherence group. Drop-out was reported in 100% of the RCTs and approximated 10% for intervention and control conditions. Adherence and compliance were reported in approximately 50% and 10% of the RCTs, respectively, and approximated 80% and 70%, respectively. Standardized metrics for reporting adherence and compliance are important in future RCTs for understanding the impact on outcomes and translation of research evidence into practice.

The Health Innovation Series: Translating Research Evidence into Practice.

Electronic medication systems (EMS) improve medication safety in hospitals; however require modifications to optimize their performance. Drawing on a five-year program of research, we developed the Health Innovation Series to disseminate recommendations arising from our research to a wide audience. Each issue contains EMS optimization tips that can be actioned by EMS managers and system vendors, as well as user tips for health professionals including nurses, doctors and pharmacists. Five issues were released by 30 Nov 2022, via two email campaigns, with further issues planned. The five issues had 2,035 downloads by March 2023. The most recent email campaign open and click rates indicate very good audience engagement.

Researchers’ views on and practices of knowledge translation: an international survey of transfusion medicine researchers

BackgroundHealth research is often driven by the desire to improve the care and health of the community; however, the translation of research evidence into policy and practice is not guaranteed. Knowledge translation (KT) activities, such as dissemination and end-user engagement by researchers, are important to achieving this goal. This study examined researchers’ views on and practices of KT in the field of transfusion medicine.MethodsAn anonymous, cross-sectional survey was distributed to transfusion medicine researchers in May 2022 by emailing corresponding authors of papers in four major blood journals, emailing grant recipients, posting on social media, and through international blood operator networks. Comparative analyses were conducted for career stage, work setting, research type, and KT training.ResultsThe final sample included 117 researchers from 33 countries. Most participants reported that research translation was important (86%) and felt it was their responsibility (69%). Fewer than half felt they had the skills to translate their research (45%) or knew which strategies to employ (45%). When examining how research findings are shared, most reported using diffusion activities (86%), including publishing in peer-reviewed journals (74%), or presenting at academic conferences (72%). Fewer used dissemination methods (60%), such as developing educational materials (29%) or writing plain language summaries (30%). Greater use of tailored dissemination strategies was seen among researchers with KT training, whilst traditional diffusion strategies were used more by those working in an academic setting. Most participants had engaged end-users in their research (72%), primarily to consult on a research component (47%) or to involve them in the research process (45%). End-user engagement was greater among researchers with established careers, working in both academic and applied settings, and with KT training.ConclusionsWhilst participating researchers acknowledged the importance of KT, they typically focused on traditional diffusion strategies. This is despite well-established knowledge of the limited impact of these strategies in achieving KT. Those with KT training were more likely to use tailored dissemination strategies and engage end-users in their research. This demonstrates the value of sharing knowledge from the KT field with health researchers to facilitate KT.

Communicating evidence synthesis: co-designing summary formats with end users

Abstract Background Evidence syntheses are essential to the creation of evidence-based guidelines that guide health care. Findings from our recent mixed methods systematic review (MMSR) identified no gold standard format for communicating summaries of evidence syntheses to guideline development groups. This is important as these groups are comprised of patients, healthcare providers, policymakers, etc., who all have different expertise, perspectives and priorities. Our overall aim is to develop evidence-informed prototype summary formats for use in guideline development. To inform this process, we held online co-design focus group workshops shaped by findings from our MMSR. Methods We held six focus groups with 30 participants involved in developing guidelines and/or evidence synthesis (February - March 2023). The topic guide was informed by the MMSR -- focusing on recommendations with mixed methods support, ≥3 supporting studies, and those prioritised by an expert advisory group through a pragmatic prioritisation exercise using the MoSCoW method (Must, Should, Could, and Will not haves). Focus groups were recorded and transcripts were analysed using a directed content analysis. Results Participants suggested a “less-is-more” structured approach that minimises methodological steps and statistical data, promoting accessibility to all audiences by judicious use of links to the full technical report. They emphasized the importance of concise consistently-presented formats which emphasize key messages, flag readers to indicators of trust in the producers (i.e., logos, websites, and conflict of interest statements), and highlight the quality of evidence. Conclusions Project findings are informing the creation of accessible and actionable guidance on best-practices for creating summary formats. Next steps involve user-testing prototype formats through semi-structured interviews which will then be integrated into the National Clinical Guideline development process in Ireland. Key messages • Co-design workshops delineated key aspects of effective and acceptable evidence synthesis summary formats to help create reproducible format templates for use in clinical guideline development. • Creating summary formats accessible to all guideline development group members will promote better communication and translation of research evidence into recommendations and practice.

Diabetes prevention at scale: narrative review of findings and lessons from the DIPLOMA evaluation of the NHS Diabetes Prevention Programme in England.

The Diabetes Prevention Programme is a large-scale, England-wide behaviour change programme for people at high risk of progressing to type 2 diabetes. We summarise the findings of our six-year DIPLOMA evaluation of its implementation and impact and highlight insights for future programmes. Using qualitative interviews, document analysis, observation, surveys and large dataset analysis, eight interlinked work packages considered: equity of access; implementation; service delivery and fidelity; programme outcomes; comparative effectiveness and cost-effectiveness in reducing diabetes incidence; and patient decision making and experience. Delivery of the NHS-DPP encountered barriers across many aspects of the programme, and we identified inequalities in terms of the areas, organisations and patient populations most likely to engage with the programme. There was some loss of fidelity at all stages from commissioning to participant understanding. Despite these challenges there was evidence of significant reductions in diabetes incidence at individual and population levels. The programme was cost-effective even within a short time-period. Despite the challenge of translating research evidence into routine NHS delivery at scale, our findings suggest that an individual-level approach to prevention of type 2 diabetes in a 'high-risk' population was more effective than usual care. By embedding evaluation with programme delivery and working closely with the NHS DPP team, we provided actionable insights for improving communications with potential participants, supporting primary care referral, honing the delivery model with better provider relationships and more patient choice, increasing understanding of behaviour change techniques, and enriching the educational and health coaching content.

Nurse engagement in antibiotic time-outs: The collaborative process of leveraging design to disseminate research findings.

Research findings and knowledge translation are typically disseminated via presentations at professional meetings and publication in peer-review journals. However, other opportunities to translate research evidence into practice exist, including the use of visual cues. The aim of this paper is to describe the collaborative process of translating key research findings into a clear and compelling visual communication tool. As part of a multimodal research dissemination strategy, the researchers partnered with the University Health Communication Design Program faculty to develop a visual communication strategy to promote the use of antibiotic time-outs by nurses in a health system. An environmental poster was identified as an appropriate mode of communication for its potential to convey a message quickly, impactfully, and economically. Five-step systematic approach, including feedback from end-users. To augment our research dissemination strategy, an action-oriented visual communication tool in the form of a 36x48 inch poster was created within four weeks and placed in the work environment. Unit nursing leaders and staff decided on poster locations for maximum nurse engagement with the message. Creating visual communication to display scientific information is an important skill, but most nurse researchers never receive any formal training that encourages participation in collaborative development of visual communication tools. Our collaboration, was iterative, reflective, and provided a unique opportunity for shared learning. Partnering with health communication designers to expand research reach and impact is invaluable and should be considered as part of a dissemination strategy. Clinical nurses' benefit from 'seeing' the science narrowed to a simple message in order to spark dialogue or remind them what they need to 'do'.

Cutting Edge Research? Realistic Expectations of Priorities, Scope and Engagement Comment on "'We're Not Providing the Best Care If We Are Not on the Cutting Edge of Research': A Research Impact Evaluation at a Regional Australian Hospital and Health Service".

While research is linked with informed decision-making and improved healthcare delivery and patient outcomes, the process of generating and translating research evidence in practice and capturing its impact can often be challenging. Based on document and database reviews and interviews in a regional Australian health system, Brown et al discuss the challenges of assessing the impact of research investments over a ten-year period. This commentary explores three inter-related lessons from this article for developing and sustaining a research culture and supporting translation in a health system: (i) achieving a shared definition and expectation of research; (ii) the importance of stakeholder engagement particularly for research prioritisation; and (iii) enabling research across a system. In doing so, it highlights the role and value of engaging knowledge generators and end-users from clinical, management and community domains not only in research development but most importantly in research prioritisation.

Professional Development and Use of Evidence-Based Practice in Autism Early Intervention

We investigated the experiences of Australian autism early intervention service providers, including the professional development they receive on the job and how they translate research evidence into their practice. Semi-structured interviews were conducted with 15 providers drawn from three locations. Participants described the crucial role of paraprofessionals in early intervention services, and indicated that, within multidisciplinary teams, allied health professionals, and teachers are the ones who select intervention practices and upskill paraprofessionals. Furthermore, participants reported using practices supported by research evidence, but also some emerging and unsupported practices. The use of unsupported practices is examined in light of the daily challenges faced by centers. Results may inform further professional development in early intervention services for children on the autism spectrum, to support the best possible outcomes for this population. The findings highlight the potential need for job-embedded hands-on professional development conducted in real time.

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

S-11-3: CLINICAL IMPLICATION OF AORTIC STIFFNESS

Modern clinical practice stresses the importance of basing healthcare practices and health policy on the best available clinical evidence. However, it is a long journey to translate research evidence into routine clinical practice through closing fundamental translational gaps. There have been numerous studies and meta-analyses demonstrating the prognostic value of arterial stiffness beyond established CVD risk factors, including age and blood pressure. Nevertheless, clinical practice guidelines rarely recommend the routine use of arterial stiffness in daily care. To facilitate the routine use of arterial stiffness measurements, the corresponding translational gaps in the clinical application should be analyzed and addressed. To justify the routine clinical use of any biomarkers, several criteria must be met. For the many methodologies to estimate arterial stiffness, their reliability and reproducibility in a standard clinical setting should be firstly demonstrated. Moreover, in a busy clinical environment, a less complicated measurement procedure with operator independence is more welcomed. Second, these techniques must carry the ability to add additional risk discrimination beyond the conventional risk prediction systems such as Framingham risk score or SCORE and should be cost effective. Not only the independent prognostic value but also the significant reclassification ability should be shown. Lastly, clear indication of the implementation of arterial stiffness techniques should be provided including but not limited to being used for risk stratification, treatment monitoring, or as a therapeutic target. Previous studies pertaining to arterial stiffness have been endeavored to address most but not all the above requirements. The independent value of arterial stiffness in predicting cardiovascular events have been presented. Moreover, its ability to predict incident hypertension and target organ damage, including brain, heart, and kidney have also been confirmed. In an individual patient data meta-analysis of cf-PWV for subjects at intermediate risk, adding cf-PWV into standard risk factors rendered a net reclassification of 15% and 27% for coronary heart disease events and CVD death, respectively. Such analysis provide justification to apply arterial stiffness measurements in routine clinical practice. They can make risk prediction more accurate by re-classifying subjects with intermediate cardiovascular risk into a higher risk level, in which treatment is indicated or into a lower risk level, in which further therapy could be safely avoided. In subjects with intermediate risk such as whitecoat hypertension, isolated diastolic hypertension, or borderline hypertension, the uncertainty in risk prediction may be further reduced by measuring arterial stiffness. Of the techniques for estimating arterial stiffness, advantages and disadvantages of each technique are observed. Although cf-PWV has the strongest evidence base supporting clinical value, the operator independence limits its widely use in routine practice. Cuff-based devices require less training, but may be less accurate. Further research is required to address this important unmet need. Besides, recommendation of the routine use of arterial stiffness techniques could be further supported by conducting randomized controlled trials adopting arterial stiffness as a treatment target, a treatment monitoring instrument, or as a tool incorporated in the intervention strategies such as risk stratification for subjects with intermediate risk profiles. To obtain health insurance reimbursement, cost-effectiveness analysis accompanied with the prospective studies for arterial stiffness is also warranted to support its routine clinical implement. In summary, the distinctive clinical value of arterial stiffness techniques relies on the ability of a single assessment to provide important information regarding blood pressure progression and susceptibility to end organ damage. The most useful scenario seems to be the more accurate risk classification for subjects at intermediate CVD risk, in which condition the need for treatment is uncertain, such as patients with masked or white coat hypertension. Therefore, arterial stiffness can be seen as complimentary to current blood pressure, and both should be considered when risk prediction is required for making timely and relevant treatment decisions. The role of arterial stiffness as a treatment target, treatment monitoring strategy in response to therapy, or a tool in the intervention strategy should be further uncovered in prospective studies or randomized controlled trials.

Turning research evidence into teaching action: Teacher educators’ attitudes toward evidence-based teaching

Teacher educators are seen as potential brokers able to bridge the research-practice gap and accelerate the adoption of current evidence in teacher education. The present study focuses on the in-depth exploration of teacher educators’ attitudes toward evidence-based teaching practices and provides a deeper understanding of the challenges encountered when turning evidence into teaching action. Moreover, facilitating factors to foster the implementation of evidence-based teaching are explored. Twelve teacher educators working in various teacher education programs in Germany reflected on challenges and facilitators to evidence-based teaching implementation. Thematic analysis was used to analyze the data. Results indicate that although teacher educators show positive attitudes towards evidence-based teaching, they still feel challenged to translate research evidence into their teaching practice. Our research suggests that evidence-based teaching may not be successfully implemented if teacher educators lack appropriate preparation and support from higher education institutions.

Co-design of the web-based 'My Knee' education and self-management toolkit for people with knee osteoarthritis.

Describe the co-design process and learnings related to developing the web-based Translating Research Evidence and Knowledge (TREK) 'My Knee' education and self-management toolkit for people with knee osteoarthritis. Stage (i): Understand and define; systematically reviewed education interventions in published trials; appraised web-based information about knee osteoarthritis; and used concept mapping to identify education priorities of people with knee osteoarthritis and physiotherapists. Stage (ii): Prototype; created a theory-, guideline- and evidence-informed toolkit. Stage (iii): Test and iterate; completed three co-design workshops with end-users (i.e., people with knee osteoarthritis and health professionals); plus an expert review. The toolkit is available at myknee.trekeducation.org. Stage (i) identified the need for more accurate and co-designed resources to address broad education needs generated during concept mapping, including guidance on surgery, dispelling common misconceptions and facilitating engagement with exercise therapy and weight management. A theory- and research-informed prototype was created in Stage (ii) to address broad learning and education needs. Stage (iii) co-design workshops (n = 15 people with osteoarthritis and n = 9 health professionals) informed further content creation and refinement, alongside improvements to optimise usability. Expert opinion review (n = 8) further refined accuracy and usability. The novel co-design methodology employed to create the TREK 'My Knee' toolkit facilitated the alignment of the content and usability to meet the broad education needs of people with knee osteoarthritis and health professionals. This toolkit aims to improve and facilitate engagement with guideline-recommended first-line care for people with knee osteoarthritis. Future work will determine its effectiveness in improving clinical outcomes in this population.

Evidence-Based Practice: Nurses’ Knowledge and Implementation in the Prevention of Pressure Sore Amongst Debilitating Patients in Selected Government Hospitals, Delta State

Evidence-Based Practice: Nurses’ knowledge and implementation; in the prevention of Pressure sore amongst debilitating patients was carried out in selected Government Hospitals in Delta State. The research method for the study was a correlational survey design. A simple random sampling was used to select 250 respondents. Permission to collect data was sought from the Ethical Committee of the Hospital Management Board and from respondents. The data collection instrument was a self-developed structured questionnaire that was validated before use. Data were analyzed using descriptive statistics, and the test statistic used for the hypotheses was the Pearson Product Moment Correlation Coefficient at 95% CI (i.e., at 0.05 significance level). The results demonstrated 54.4% had knowledge of EBP, 19.6% of nurses employed EBP to prevent pressure sore while and 19.6% employed best practice. There exists a significant relationship between nurses’ level of knowledge of EBP and the prevention of Pressure sore in debilitating patients (r=0.338, df-248, p<0.05). There was a relationship between the implementation strategy of EBP and the prevention of Pressure sore in debilitating patients (r=0.258, df-248, p<0.05). This study revealed the majority had knowledge of EBP. However, there is still a wide gap in knowledge as 38.8% of nurses indicated that opinion, expertise, and intuition are sufficient in preventing Pressure sore in debilitating patients. Nurses are to use nursing models. Models not only increase patient’s satisfaction and quality of nursing care but also offer a useful set of frameworks to guide education and nursing practice as failure to translate research evidence into practice hinders patients from adequate care and is likely to have skin breakdown. Keywords: Evidence-based practice, Implementation, Nurse’s knowledge, Pressure sore, Prevention.

From evidence to implementation of lifestyle behaviour in cancer prevention and control: A Preventive Medicine Golden Jubilee Commentary

Preventive interventions targeting tobacco, alcohol, healthy diets and physical activity are key strategies to tackle the most pressing health challenges in modern society. A major gap remains in how to translate research evidence into population-level behaviour change to reduce the disease burden. We use the case for the role of physical activity-related behaviour and cancer to illustrate the iterative, multidirectional, and transdisciplinary nature of translational research. The issues we address in this context are generalizable and applicable to other behavioral risk factors and non-communicable diseases. There is now solid evidence that physical activity reduces cancer risk and improves outcomes after cancer diagnosis. Here we provide a framework for how to implement this knowledge into real-world settings. We provide the rationale for combining systems, causal and design thinking to develop interventions that can be implemented for this type of behaviour change. The proposed model is iterative, multidirectional and transdisciplinary. We identify major knowledge gaps in epidemiology and science of behaviour change on physical activity and cancer control and propose approaches to suggest priorities for future research.

The effect of multicomponent approach in enhancing the level of confidence with evidence-based practice activities and promoting evidence-based practice culture among nurses in a clinical setting in the United Arab Emirates.

The aim of this work is to examine the effect of multicomponent interventions on enhancing the level of confidence of staff nurses with evidence-based practice in an acute care hospital in the United Arab Emirates. Evidence-based practice is one of the strategic pillars of nursing practice and a key to organizational success. To effectively implement and sustain evidence-based practice programmes in clinical sites, well-designed implementations can promote staff attitude, knowledge, skills, and confidence in translating research evidence into optimal patient care. Experienced and bachelor prepared nurse managers in collaboration with the clinical resource nurse undertook condensed staff training and interventions for the evidence-based practice programme, where 70 registered nurses participated. The intervention was conducted over a period of time extending from December 2019 until December 2020. The study design is quasi-experimental using the pre- and post-Self Efficacy Assessment tool to gauge the nurses' confidence in evidence-based practice. Also, SPSS software was used to explore the effect of the programme. Higher significant score on the evidence-based nursing practice self-efficacy scale postprogramme was noted (t= -7.667 and p value <.001). Participating in a well-structured evidence-based practice programme would positively enhance the nurse's confidence in the programme implementation and promote an evidence-based practice culture in clinical settings. Nurse managers must recognize their critical role in promoting evidence-based practice among nurses. A focused and well-designed intervention may assist in establishing a culture of evidence-based practice to ensure the best patient outcome.

Clinical Practice Guidelines: The Road Map to Better Care

Earlier this year, I wrote about the worth of systematic reviews in rehabilitation literature.1 Systematic reviews and meta-analyses are important tools in translating research evidence into clinical practice as they critically evaluate and summarize the body of evidence on clinical topics. Clinicians can use these studies to quickly survey the current literature base to increase understanding of a clinical diagnosis they make, with the intent of using this information to improve their clinical practice. A well-written systematic review or meta-analysis, with critical evaluation of study quality, is then that Cliffs Note version of what to know and what to do. Therefore, with the proliferation of systematic reviews and meta-analyses, we should see a corresponding change in clinical practice, with more effective and more efficient ways to help those with cancer recover function and quality of life. However, in the 2 decades since the Institute of Medicine called on a new health system for the 21st century,2 the translation of evidence into practice still occurs at a snail's pace, with an average lag of 17 years from research publication to clinical adoption.3–5 How then do we move the needle on providing evidence-based care? Knowledge translation and implementation are helped through the development and publication of quality clinical practice guidelines (CPGs). A CPG takes the systematic review process to the next level by moving from reporting what the literature says to making recommendations for practice based on an extensive review of the literature analyzed by experts in the field. CPGs should be rigorously conducted and meet the following criteria: an extensive and systematic search of the literature on the specific topic; critical analysis of the quality of the included studies; a synthesis and analysis of the cumulative results of those studies; and a clear set of recommendations for clinical practice based on weighing the benefits, harms, and alternatives to care. Experts in the field construct these documents, and important stakeholders give their input on the questions to be answered and the clarity of the documents produced. This process of carefully searching and evaluating the literature, determining risks and benefits, and then synthesizing the quality and findings of the studies with the cumulative risk-to-benefit ratio leads to making recommendations that, when implemented, improve patient care. These qualities are the hallmark of a good CPG.6,7 CPGs, like systematic reviews, are only useful if the conclusions drawn and recommendations made are used in clinical practice. To effect clinical care, a good-quality CPG must be adopted. The primary way to move CPGs into practice is by their incorporation into educational curricula across the spectrum including curriculum for entry-level professional programs, residency training, continuing education courses, and educational resources7 for practicing clinicians. The depth and breadth of the evidence coalesced into a CPG provide definitive recommendations for best practices and only by embedding them into education at all levels, from entry-level to advanced practice, can we move clinical practice forward. Our Academy (APTA Oncology) has sponsored the development of CPGs for the oncology population. Through the support of APTA, APTA Oncology has completed the third Academy CPG focusing on screening and assessment of cancer-related fatigue (CRF). Published in Physical Therapy and Rehabilitation (DOI link pending), this issue presents the Executive Summary of the CPG for Screening and Assessment of Cancer-Related Fatigue.8 Included are useful tables summarizing best measures for use at different points in the cancer care continuum, with specific cancer populations, and in what languages the tools are available. A figure depicting the decision-making path provides useful algorithm for clinicians. All of these tools are important for successful clinical implementation. This Executive Summary, and the other research reports in this issue, provides useful evidence to improve the rehabilitative care of the individual with cancer. Using CPGs as a road map to better care depends on practicing clinicians and educators; we can only move practice forward by implementing the CPG recommendations. Just as our profession is moving forward with developing CPGs, Rehabilitation Oncology is moving forward as well. As the official journal of APTA Oncology, we will transition to an online-only journal with the first issue of 2023. This change reflects our fiduciary responsibility to you and our environment by reducing expenses related to the increasing costs of print and reducing use of valuable resources. Readers will still be able to access all of the content in the print version, with an increase in digital pages to publish more relevant research, but will now be available exclusively online at http://www.rehabonc.com.