Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in heal
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RESEARCH
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Barriers, facilitators and views about next steps to implementing supports for evidence-informed decision-making in health systems: a qualitative study Moriah E Ellen1,2,3,4, Grégory Léon5, Gisèle Bouchard5, Mathieu Ouimet5, Jeremy M Grimshaw6,7 and John N Lavis2,3,8,9,10*
Abstract Background: Mobilizing research evidence for daily decision-making is challenging for health system decision-makers. In a previous qualitative paper, we showed the current mix of supports that Canadian health-care organizations have in place and the ones that are perceived to be helpful to facilitate the use of research evidence in health system decision-making. Factors influencing the implementation of such supports remain poorly described in the literature. Identifying the barriers to and facilitators of different interventions is essential for implementation of effective, context-specific, supports for evidence-informed decision-making (EIDM) in health systems. The purpose of this study was to identify (a) barriers and facilitators to implementing supports for EIDM in Canadian health-care organizations, (b) views about emerging development of supports for EIDM, and (c) views about the priorities to bridge the gaps in the current mix of supports that these organizations have in place. Methods: This qualitative study was conducted in three types of health-care organizations (regional health authorities, hospitals, and primary care practices) in two Canadian provinces (Ontario and Quebec). Fifty-seven in-depth semi-structured telephone interviews were conducted with senior managers, library managers, and knowledge brokers from health-care organizations that have already undertaken strategic initiatives in knowledge translation. The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. (Continued on next page)
* Correspondence: [email protected] 2 Centre for Health Economics and Policy Analysis, McMaster University, 1280 Main Street West, CRL 209, Hamilton, Ontario L8S 4K1, Canada 3 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada Full list of author information is available at the end of the article © 2014 Ellen et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Ellen et al. Implementation Science (2014) 9:179
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Results: Limited resources (i.e., money or staff), time constraints, and negative attitudes (or resistance) toward change were the most frequently identified barriers to implementing supports for EIDM. Genuine interest fr
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