7 steps to implement KT

It is possible to change practice and improve patient care – but sadly a lot of attempts, including research feasibility studies fail to do this effectively. We have started to document the reasons for failure and to put a positive spin on these ‘barriers’ for implementation.  Management theory is full of guides to introduce and manage changePsychological theory also helps to explain personal attitudes, willingness and satisfaction with change. A recent 7 phase process has been developed to bring together 2 important conceptual frameworks; the Knowledge-to-Action cycle and the Medical Research Council framework. It offers great promise to simplify some of this complexity in a systematic and consistent way. In short the 7 phases can ideally be described as;

  1. Identify the problem – review what is known, in relation to research evidence, patient and clinician knowledge
  2. Adapt the knowledge – critically appraise research evidence, apply to the local context
  3. Assess barriers and facilitators – inform design of intervention and implementation plan
  4. Select and tailor intervention – fit intervention to local context and patient values
  5. Implement intervention and monitor knowledge use – plan, check, adjust change in practice
  6. Evaluate outcomes – document improvement from multiple perspectives, including clinical outcomes
  7. Sustain ongoing knowledge use – ensure long-term continuation of improvement

The challenge now is to use this structured process in a flexible and appropriate way to plan, implement and document KT activities. It would be great if this could guide the growth of evidence for future KT implementations…


I conduct and supervise research that promotes the translation of quality research evidence for use in clinical practice.

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