Infuse Issue 8 June 2019 | Página 11

If we want the best care for our patients
or clients, then why don’t we just do it?
Is it really that simple or is there more to
it? You may have been involved in clinical
research trials (knowledge generation),
systematic reviews or guideline
development (knowledge synthesis and
dissemination). But how do we take the
next step on the road to implementation?
When faced with new research findings
or guidelines, many are tempted to jump
straight to “the doing” but the emerging
field of implementation science tells us
that understanding the large and complex
real-world settings we
work within, and the
potential barriers and
facilitators to change,
are more likely to lead
to successful and
sustainable research
translation.
to engage with clinicians and consumers
to improve adherence to clinical guideline
recommendations. A clinical audit
established baseline adherence to the
evidence-based guidelines and clinical
parameters prior to implementation in a
prospective cohort. Qualitative interviews
with consumers and clinicians identified
barriers and facilitators to change at
individual, team and system levels. The
key interventions utilised included a
supportive care-led pre-treatment clinic
and a nutrition care dashboard integrated
into weekly multidisciplinary team
discussions. We
employed a series
of evidence-based
implementation
strategies which
included: clinical
practice change
strategies;
multidisciplinary team
engagement; integration
with existing care;
information technology
strategies; audit and
feedback; staff
education and support;
and harnessed the
sponsorship of
organisational opinion
leaders. Lastly, we
also conducted focus groups to obtain
feedback on the new model of care while
economic analysis determined system-
level impact.
Take, for example, my
recent experience with
a National Health and
Medical Research
Council Translating
Research Into Practice
Fellowship where we
aimed to implement an
innovative model of
nutrition care for
patients with head and neck cancer
based upon the best available evidence. 2,3
In taking an implementation science
approach to this research, we utilised a
mixed-methods pre-post study design
© Dietitian Connection
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Infuse | June 2019