Article type
Year
Abstract
Background: journal clubs (JCs) are a well-recognized, quality-improvement strategy used by health practitioners to update relevant health literatures. JCs are also used in the evidence-based practice (EBP) education of healthcare professionals. However, it is unclear that JCs can promote translating evidence 'from bench to bedside' in real-world practice.
Objectives: the aims of this study were to assess the outcomes of JCs for promoting knowledge translation (KT) in a real-world, clinical setting. In addition, we also want to identify the facilitators and barriers of KT.
Methods: the JCs were held regularly, every other week, in a medical center in Northern Taiwan. Assigned facilitators were responsible for choosing topics relevant to clinical care and quality improvement, and identifying the current best evidence before the JC's meeting. Multidisciplinary teams were invited according to the JC's topic. We used the 'evidence pipeline' model (Glasziou & Haynes, 2005), which contains seven barriers of evidence use (awareness, acceptance, applicable, available and able, acted on, agreed to, and adhered to), to evaluate the results of KT. We tracked the number of changes of previous standard of procedures (SOPs) as the result of JCs and used content analysis to identify the facilitators and barriers of KT.
Results: a total of 131 JCs were held every other week from 2012 to 2019. There were 195 participants. Up to now, only 29% (38/131) os JCs' discussion issues have finally become guidelines or SOPs in real-world clinical settings. The facilitating factors of KT were:
1) leadership and organization culture;
2) physician participation; and
3) external audit.
The barriers of KT include:
1) lack of time to read, discuss or implement the evidence;
2) research outcomes and statistical analyses are not understandable;
3) healthcare providers feel they don’t have enough authority to change patient care procedures.
Conclusions: this study demonstrated that only less than one-third of JCs' discussions became SOP, guideline or policy used for real-word patient care. Most front-line healthcare providers are aware of and accept the best evidence after JCs' discussion, it is obviously important but insufficient; there may be some impact on quality of care, but not enough. We should pay further attention to the other KT mechanisms, for example, additional training, integration of evidence into clinical decision aids in changing practice pattern and for shared decision making (SDM) with patients, etc. Therefore, healthcare professionals should focus on the process of strengthening the facilitators and overcoming the barriers after JCs' discussion. The goal is to promote KT in changing healthcare practice pattern.
Patient involvement: besides healthcare professionals’ participation, we also should promote SDM with patients based on best evidence to promote KT. To invite patient participation in clinical JCs will be a creative strategy to facilitate evidence use.
Objectives: the aims of this study were to assess the outcomes of JCs for promoting knowledge translation (KT) in a real-world, clinical setting. In addition, we also want to identify the facilitators and barriers of KT.
Methods: the JCs were held regularly, every other week, in a medical center in Northern Taiwan. Assigned facilitators were responsible for choosing topics relevant to clinical care and quality improvement, and identifying the current best evidence before the JC's meeting. Multidisciplinary teams were invited according to the JC's topic. We used the 'evidence pipeline' model (Glasziou & Haynes, 2005), which contains seven barriers of evidence use (awareness, acceptance, applicable, available and able, acted on, agreed to, and adhered to), to evaluate the results of KT. We tracked the number of changes of previous standard of procedures (SOPs) as the result of JCs and used content analysis to identify the facilitators and barriers of KT.
Results: a total of 131 JCs were held every other week from 2012 to 2019. There were 195 participants. Up to now, only 29% (38/131) os JCs' discussion issues have finally become guidelines or SOPs in real-world clinical settings. The facilitating factors of KT were:
1) leadership and organization culture;
2) physician participation; and
3) external audit.
The barriers of KT include:
1) lack of time to read, discuss or implement the evidence;
2) research outcomes and statistical analyses are not understandable;
3) healthcare providers feel they don’t have enough authority to change patient care procedures.
Conclusions: this study demonstrated that only less than one-third of JCs' discussions became SOP, guideline or policy used for real-word patient care. Most front-line healthcare providers are aware of and accept the best evidence after JCs' discussion, it is obviously important but insufficient; there may be some impact on quality of care, but not enough. We should pay further attention to the other KT mechanisms, for example, additional training, integration of evidence into clinical decision aids in changing practice pattern and for shared decision making (SDM) with patients, etc. Therefore, healthcare professionals should focus on the process of strengthening the facilitators and overcoming the barriers after JCs' discussion. The goal is to promote KT in changing healthcare practice pattern.
Patient involvement: besides healthcare professionals’ participation, we also should promote SDM with patients based on best evidence to promote KT. To invite patient participation in clinical JCs will be a creative strategy to facilitate evidence use.
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