Background There is strong evidence that cardiovascular training programmes for people with rheumatic diseases, which are in accordance with current recommendations for enhancing physical fitness, are effective. For many reasons, such research findings often have little impact on clinical practice and it may be rather luck than planning, when research findings lead to a change in diagnostic or therapeutic procedures.
Objective To present an overview of dissemination and implementation strategies and illustrate this with the example of implementing effective cardiovascular training for people with rheumatic diseases, e.g. Ankylosing Spondylitis (AS), in daily clinical practice.
Methods The features of effective cardiovascular training and an overview of what an implementation process involves will be discussed.
Generally, one of the two following approaches are applied: the more structured “rational model”, where new findings are considered worth to be introduced into routine and subsequently are disseminated and implemented with steering from external and above, or the “participation model”, which works bottom up, innovation is introduced incrementally and steered from practice.
Different theories from other disciplines and scientific areas can be used to support the process of change, i.e. theories that address the individual health professionals’ behaviour change, theories that focus on the social interaction and context and finally, theories on factors related to the organisational or economic context.
The implementation process itself is a systematic approach with clear strategies for dissemination, implementation and/or maintenance (1). In a project plan various steps must be addressed, such as attainable aims, the analysis of the target group and the setting, including the identification of barriers and facilitators for change as well as concrete activities and tasks within a schedule. After testing and executing the implementation plan, the final step is to evaluate the results in order to improve and adapt the procedures if necessary.
Conclusions The key to successful implementation is a well planned and prepared process and systematic approach, no matter if the project is large or small and independent from aims, content or setting. Effective implementation helps to close the gap new evidence and daily practice and to provide the best available care to patients.
Grol R, Wensing M. What drives change? Barriers and incentives for achieving evidence-based practice. MJA. 2004, 180:557-60.
Disclosure of Interest None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.