Why is the implementation of evidence to the clinical practice setting so challenging? By Jane Watson
I have become a real fan of Twitter and enjoy the sharing of new research and professional practice ideas. I was however greatly saddened to read Dr Mark Levy’s tweet on the 15th January 2019, "Just came from inquest in London on another sad childhood #asthma #death where the coroner concluded that management was inadequate. Still no National Implementation of #NRAD or adherence to UK guidelines."
I was saddened for two reasons, firstly because a child has died and secondly the death was the result of inadequate care. Dr Levy highlights non-adherence to Asthma clinical guidelines had an important part to play in this situation. Which I have no doubt is true, for me though the bigger question is why is the implementation of evidence to the clinical practice setting so challenging? And why is this critical process so frequently overlooked?
Clinicians are able to offer many insights to this phenomenon, ultimately because they are emerged within clinical environments. If we want to understand why guidelines are not implemented in practice, we need to ask those who are responsible for applying them. As such encouraging clinicians to engage with research is therefore very important.
However, in the long-term implementation of evidence to practice, must be considered at the outset and not as an afterthought. Safe effective health care needs collaboration between clinicians, researchers, stakeholders and patients in order to achieve greater harmony between evidence recommendations and the practical application of this within complex clinical environments.
Within my own research I am seeking to understand why health care professionals do not adhere to clinical guidelines within the realms of Pulmonary Rehabilitation. (I will be asking for your views on this in the next few months so please do watch this space and please contribute to my upcoming survey).