Knowledge to Action?: Evidence-Based Health Care in Context

Health services can and should be improved by applying research findings about best practice. Yet, in Knowledge to Action?, the authors explore why it nevertheless proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures. The book draws on a large body of evidence acquired in the course of nearly fifty in-depth case studies, following attempts to introduce evidence-based practice in the UK NHS over more than a decade. Using qualitative methods to study hospital and primary care settings, they are able to shed light on why some of these attempts succeeded where others faltered. By opening up the intricacies and complexities of change in the NHS, they reveal the limitations of the simplistic approaches to implementing research or introducing evidence-based health care. A unique synthesis of evidence, the book brings together data from 1,400 interviews with doctors, nurses, and managers, as well as detailed observations and documentary analysis. The authors provide an analysis, rooted in a range of theoretical perspectives, that underlines the intimate links between organizational structures and cultures and the utilization of knowledge, and draws conclusions which will be of significance for other areas of public management. Their findings have implications for the utilization of knowledge in situations where there is a professional tradition working within a politically sensitive blend of public service, managerial accountability, and technical expertise. Knowledge to Action? will be of interest to Academics, Researchers, and Advanced Students of Organizational Behaviour, Public and Health Management, and Evidence-Based Medicine; and also of particular interest to Practitioners, Clinicians, and Public Health Managers concerned with implementing change to clinical practice.

Table of Contents:
1. Introduction ; 2. Studying Complex Organizations in Health Care ; 3. Evidence-Based Health Care and the Implementation Gap ; 4. Research Design: 'Upscaling' Qualitative Research ; 5. The Active Role of Context ; 6. Professional Boundaries and the Diffusion of Innovation ; 7. Knowledge, Credible Evidence, and Utilization ; 8. Knolwedge in Action ; 9. Conclusion: From Evidence to Actionable Knowledge?

About the Author :
Sue Dopson is Rhodes Reader in Organizational Behaviour, Saïd Business School, and Fellow of Templeton College, University of Oxford. A member of the Oxford Health Care Management Institute, she is involved in the development of courses for the NHS and a number of research projects, including the evaluation of projects aimed at improving clinical effectiveness, exploring issues of getting the results of medical research evidence into clinical practice, and more general research in the area of NHS management. She has published several books and articles on changes in the management of the NHS, the changing nature of middle management, management careers, and developments in public sector management. Louise Fitzgerald is Professor of Organizational Development in the Department of Human Resource Management at De Montfort University. She completed her PhD whilst a lecturer at Salford University, was a Senior Lecturer at Warwick University, and a Professor and Director of Research at St. Bartholomew's School of Nursing and Midwifery, City University. Her research interests centre on the management of change in professional organizations, particularly health care, and she has published widely in journals such as Human Relations, Personnel Review, and the Journal of Health Services Research and Policy, as well as having co-authored several books including The New Public Management in Action (OUP, 1996).

Review :
It represents a breath of fresh air and contains lessons for those both producing and implementing evidence in EBM (Evidence Based Medicine). Although written as an academic book, it's readibility and numerous case studies allow it to drift close to being a 'how to' manual for implementing EBM. British Medicine Journal (BJM) Based on more than 50 studies of attempts to implement evidence based health care in different NHS settings, it provides a comprehensive and thoughtful review... British Medical Journal ...this book is an important advance... Administrative Science Quarterly