How to Implement Evidence-Based Healthcare

Title Page
Copyright Page
Contents
Foreword
Acknowledgements
Chapter 1 Introduction
	1.1 The story of this book
	1.2 There is no tooth fairy …
	1.3 Outline of this book
	References
Chapter 2 Evidence
	2.1 (Research) Evidence
	2.2 Knowledge translation, knowledge transfer
	2.3 Different worlds
	2.4 Attributes of innovations
	2.5 Ten tips for translating evidence
		1. Shorten
		2. Sharpen
		3. Tailor
		4. Narrativise
		5. Visualise
		6. Recruit key messengers
		7. Mobilise the media
		8. Blog
		9. Tweet
		10. Bundle
	References
Chapter 3 People
	3.1 Introduction
	3.2 Theories of human behaviour – an eclectic selection
		‘Fast’ and ‘slow’ thinking; heuristics; cognitive biases (Kahneman, Gigerenzer)
		The theory of planned behaviour (Ajzen and Fishbein)
		Learning domains: knowledge, skills and attitudes (Bloom)
		Adult learning theory (Kolb, Knowles)
		Social learning theory and self‐efficacy (Bandura)
		Dynamic (‘stages of …’) change theories (Prochaska/Diclemente, Rogers, Grol)
	3.3 ‘Why don’t clinicians follow guidelines?’
		Michie et al.’s taxonomy of behaviour change theories
		Cabana et al.’s model of barriers to physician adherence to guidelines
		Grol’s three-level model for guideline adherence
	3.4 Interventions aimed at changing clinician behaviour
		Interventions that prompt, reward, or feed back on behaviour
		Interventions that seek to improve knowledge
		Interventions that promote the use of heuristics
		Interventions that promote adult (on‐the‐job) learning
		Interventions that promote social influence
		Sequential interventions tailored to the intended adopter’s stage of change
	3.5 Ten tips for influencing how people behave
		1. Don’t think of people as empty buckets or blank slates
		2. Think fast – and slow
		3. Know your cognitive biases
		4. Challenge stock theories of behaviour change
		5. Get familiar with the basics of learning theory
		6. Think of behaviour change as occurring in stages …
		7. … and also as influenced at different levels
		8. Distinguish ‘factors’ (barriers, facilitators) from explanations
		9. Understand the limitations of experimental trials of interventions to change behaviour
		10. Build capacity
	References
Chapter 4 Groups and teams
	4.1 Introduction: no man (or woman) is an island
	4.2 Leadership
	4.3 Facilitation and team learning
	4.4 Empirical studies of leadership and facilitation
	4.5 Ten tips for leading and facilitating teams
		1. Understand the mathematics of group work
		2. Attend to the team’s physical and material needs
		3. Assess the context in which you will be working, and the implications for the preferred leadership style
		4. Don’t be a wuss
		5. Select your team carefully, and justify to everyone why people have been included
		6. Clarify the task objectives and measures of success with your team
		7. When facilitating a team, take account of task(s), context and team preparedness
		8. Attend to people issues as well as task issues
		9. Give plenty of feedback (both ‘hard’ and ‘soft’)
		10. Attend to the cycle of team learning (single‐, double‐ and triple‐loop)
	References
Chapter 5 Organisations
	5.1 The diffusion of innovations model
	5.2 Structural determinants of organisational innovativeness
	5.3 Absorptive capacity and receptive context
	5.4 Organisational readiness and the assimilation decision
		Tension for change
		Innovation–system fit
		Assessment of implications
		Support and advocacy
		Dedicated time and resources
		Capacity to evaluate the innovation
	5.5 Implementation: balancing ‘hard’ and ‘soft’ efforts
		SMART objectives
		Staff involvement and commitment
		Human resources
		Tools and techniques
		Intra-organisational networks
		Extra-organisational networks
	5.6 Routinisation and sustainability
	5.7 Ten tips for promoting organisational innovation
		To build your organisation’s general capacity to innovate
		To support the introduction of a specific innovation
	References
Chapter 6 Citizens
	6.1 Citizens, the public, lay people – who are they (we)?
	6.2 Lay involvement in research: how much and on whose terms?
	6.3 ‘We ask the questions’: moving beyond a  researcher‐focused EBHC
	6.4 Conducting research with (as opposed to on) patients
	6.5 Communicating research: whose literacy is the problem?
	6.6 Ten tips for improving citizen involvement in research
		1. Persuade yourself that citizen involvement matters
		2. Use the right terminology
		3. Understand what excellent looks like
		4. Prioritise research questions that patients themselves pose
		5. Conduct research with, not on, patients
		6. Go further: co-create research
		7. Learn to write (and speak) in plain English
		8. Involve patients, citizens and the lay media in disseminating research findings
		9. Get out more
		10. Invite the public in
	References
Chapter 7 Patients
	7.1 Is the EBHC movement biased against patients?
	7.2 Implementing evidence with patients in the clinical encounter
	7.3 Self-management and how to support it
	7.4 Patient involvement in service improvement
	7.5 Ten tips for improving evidence‐based patient care
		Clinical care
		Service improvement
		Research
	References
Chapter 8 Technology
	8.1 The myth of technological determinism
	8.2 Apps to support evidence‐based (self‐)management?
	8.3 Why do patients resist technologies?
	8.4 Why do clinicians resist technologies?
	8.5 Ten tips for using technologies to support EBHC
		1. Get real about where you lie on the geek spectrum
		2. Move beyond technological determinism
		3. Stop and think before designing an app
		4. Learn more about how patients live with illness
		5. Take randomised trials of technology‐on versus technology‐off with a pinch of salt
		6. Read more about design
		7. Study tasks and processes in organisations
		8. Take a course in ethnography
		9. Learn, and apply, the principles of sociotechnical design in organisations
		10. If you want technology‐supported change, resource it
	References
Chapter 9 Policy
	9.1 Evidence-based policy: beyond ‘barriers and facilitators’
	9.2 How does policymaking actually happen?
	9.3 Value-based healthcare – and how values shape evidence
	9.4 Ten tips for closer alignment between research and policy
		1. Recognise the wide range of evidence that gets used by policymakers
		2. Get your head round why most research is not useful to policymakers
		3. Learn and apply some health economics
		4. Consider the four ways in which research evidence is actually used by policymakers
		5. Build relationships with policymakers
		6. Produce policy-relevant summaries of evidence
		7. Be aware of the power of framing – and develop frame awareness
		8. Value data – but remember that all data are value‐laden
		9. Work actively to bridge the ‘two cultures’ divide
		10. Seek to influence research policy
	References
Chapter 10 Networks
	10.1 Networks and knowledge
	10.2 Social network analysis
	10.3 Professional communities of practice and ‘mindlines’
	10.4 Patient communities and the work of living with illness
	10.5 Ten tips for improving networks and networking
		1. Extend your definition of what knowledge is
		2. Revisit the section on how policymakers use evidence
		3. Know your social influencers
		4. Note the important principle of homophily
		5. Acknowledge social influence as a social process, not an experimental variable
		6. Harness the strength of weak ties for spreading ideas
		7. Support professional communities of practice
		8. Value mindlines
		9. Support patient/carer communities
		10. Learn from patient/carer communities
	References
Chapter 11 Systems
	11.1 Complex (adaptive) systems
	11.2 Realist evaluation and review
	11.3 Actor-networks
	11.4 Multi-stakeholder health research systems
	11.5 Ten tips for working with complex systems
		1. Loosen up
		2. Identify simple rules that drive actors
		3. Consider embeddedness
		4. When introducing order, look for disorder
		5. Abandon the quest for a transferable ‘effect size’
		6. Ask, ‘What works for whom in what circumstances?’
		7. Map the actors in the network
		8. Identify boundary objects
		9. Understand the organisational actors in the multi‐stakeholder research system
		10. Consider how to co‐create value for each disparate stakeholder
	References
Appendix A Frameworks, tools and techniques
Appendix B Psychological domains and constructs relevant to the implementation of EBHC
Index
EULA