The most common definition of Evidence-Based Practice (EBP) describes the explicit use of current best evidence in making decisions about individual patient care. It means integrating research evidence, with clinicians’ expertise and patient values.
Over the last 20 years, the emphasis of the EBP community has been on quantifying the quality of research evidence, often at the expense of integrating the knowledge and experience of clinicians and in understanding patient values.
At the same time, there has been an explosion in the production of research, such that it is now estimated that up to 85% of research is wasted because of flawed research designs, biased publication and poor quality reporting. Further, we know that on average, it takes 17 years for research evidence to reach clinical practice.
Therefore, the aspiration for clinicians to continually update their practice to be evidence-based is unrealistic if we rely on the passive dissemination of research evidence. Further continuing professional education about using and understanding the research evidence is not sufficient to empower clinicians to change their clinical practices.Clinicians have also realised that as individuals they are not able to comprehensively review the research evidence and lead the recommended changes in clinical practice. To fully utilise research evidence in clinical practice, there is a need to better understand the complex systems and in which clinicians work. Different theories and practices have been developed to bridge what has been commonly term, the knowledge- practice gap; the gap between what the research evidence should happen, and what really is carried in within our healthcare services
In 2005, the Canadian Institute of Health Research has describe knowledge translation (KT) as the exchange and synthesis of knowledge within complex systems of healthcare interactions, to accelerate the benefits of research for individuals and health care systems. The principles and strategies of knowledge translation can help clinicians incorporate key EBP principles in the synthesis of high quality research evidence as a key form of knowledge, together with local knowledge about current practice, clinician expertise and patient needs. Commonly clinicians access information across a broad range of sources to influence their practice
KT strategies encourage clinicians to focus on key clinical outcomes, and to identify specific aspects of behaviour change. Any change within a complex system requires the identification of key stakeholders and an analysis of local barriers and facilitators.At the same time, it is important to look for evidence of strategies to support effective individual and organisational change. To complement any implementation, it is vital to incorporate strategies to monitor and sustain positive change.