Understanding Evidence-Based Practice (EBP) Implementation in HCOs Through the Lens of Organizational Theory

摘要

Despite the increasing use of theory in the field of implementation science over the past decade, the literature has largely focused on using deterministic frameworks to retrospectively understand “what” factors are essential for the effective implementation of evidence-based practices (EBPs). On the other hand, gaps remain in using organizational theory to prospectively understand “how” successful EBP implementation occurs in health-care organizations (HCOs). This article discusses the theoretical and empirical contributions of two selected recent exploratory research works, which provide a starting point for addressing the identified gaps in the literature, with the purpose of deriving implications for theory, practice, and future research in implementation science. The selected works used the theory of “effective knowledge sharing network structures in professional complex systems (PCS),” developed through an integration of organizational theories, to design prospective interventions for enabling EBP implementation in HCOs. In doing so, these studies have helped explain “how” inter-professional knowledge exchange and collective learning occurred, to enable successful EBP implementation in HCOs. Correspondingly, the selected works have served a dual purpose in: 1) identifying evidence-based management (EBM) practice strategies for successful EBP implementation; while 2) further developing the theoretical literature on “effective knowledge sharing networks in PCS.” Importantly, by addressing the identified gaps in the literature, the selected works serve to either complement or supplement existing theoretical approaches in implementation science. To this effect, they provide unique insights for theory, practice, and research in implementation science, including insights into a potential “dual-role” for the future implementation researcher—one of advancing implementation science, while working to strengthen implementation practice. Based on these contributions, it could be argued that the selected works provide a starting point for a new research stream that has the potential to occupy a distinct position in the taxonomy of theoretical approaches used in implementation science.