Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Evidence-Based Practice

Getting Evidence Based Practice to Work within Organizations: A System Dynamics Based Meta-analysis

Purpose: Organizational issues have been cited as barriers to implementation of evidence-based practice (EBP) in the services systems, with a call for proactively attending to these issues at the front end of research on effective treatments (Bartels et al., 2002; Hoagwood, Burns, Kiser, Ringeisen, & Schoenwald, 2001; Newman, Papdopoulous, & Sigsworth, 1998; Rosenheck, 2001; Schoenwald & Hoagwood, 2001). Recent work argues for more research that helps social work develop a better understanding of how multiple interventions interact, assess the risks as well as the benefits of adopting EBP, recognizes the complex decision environments of practitioners, and pays attention to organizations in terms of stages-of change (e.g., Gira, Kessler, & Poertner, 2004). This study explicates key assumptions in the diffusion (Rogers, 1995) of evidence-based practices in order to identify high leverage points for research to impact social work practice.

Methods: The study uses system dynamics modeling (Forrester, 1999; Levin & Roberts, 1976) as framework for conducting a meta-analysis of diffusion of evidence based practice research combined with key informant interviews of agency directors. We develop a dynamic model that replicates the problems associated with incorporating evidence-based treatments (EBT) into practice.

Results: The model reveals how organizational barriers are related to the goal of increasing practitioner use of EBP in terms of nonlinear feedback loops, and identifies how organizational and professional policies can facilitate diffusion of EBP with respect to an organization’s readiness to change.

Implications: The benefits of research are only realized if the results can be incorporated into practice. Understanding the diffusion of evidence-based practice will have broad applications to both researchers and practitioners. The results will help researchers identify and define questions that can have maximum impact in terms of implementation. The results will also help clinicians and administrators incorporate policy changes to move their organizations toward the successful implementation of evidence-based practice.

Bartels, S. J., Dums, A. R., Oxman, T. E., Schneider, L. S., Arean, P. A., Alexopoulos, G. S., et al. (2002). Evidence-Based Practices in Geriatric Mental Health Care. Psychiatric Services, 53(11), 1419-1431.

Forrester, J. W. (1999). Industrial dynamics. Waltham: Pegasus Communications, Inc.

Gira, E. C., Kessler, M. L., & Poertner, J. (2004). Influencing social workers to use research evidence in practice: Lessons from medicine and the allied health professions. Research on Social Work Practice, 14(2), 68-79.

Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-Based Practice in Child and Adolescent Mental Health Services. Psychiatric Services, 52(9), 1179-1189.

Levin, G., & Roberts, E. B. (1976). The dynamics of human service delivery. Cambrdige, MA: Ballinger Publishing Company.

Newman, M., Papdopoulous, I., & Sigsworth, J. (1998). Barriers to evidence-based practice. Intensive and Critical Care Nursing, 14(5), 231-238.

Rogers, E. M. (1995). Diffusion of innovation (4th ed.). New York: The Free Press.

Rosenheck, R. A. (2001). Organizational Process: A Missing Link Between Research and Practice. Psychiatric Services, 52(12), 1607-1612.

Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52(9), 1190-1197.

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