Major difficulties arise when introducing evidence and clinical guidelines into routine daily practice. Data show that
many patients do not receive appropriate care, or receive unnecessary or harmful care. Many approaches claim to offer
solutions to this problem; which ones are as yet the most effective and efficient is unclear. We aim to provide an
overview of present knowledge about initiatives to changing medical practice. Substantial evidence suggests that to
change behaviour is possible, but this change generally requires comprehensive approaches at different levels (doctor,
team practice, hospital, wider environment), tailored to specific settings and target groups. Plans for change should be
based on characteristics of the evidence or guideline itself and barriers and facilitators to change. In general, evidence
shows that none of the approaches for transferring evidence to practice is superior to all changes in all situations.
Major difficulties arise when introducing evidence and clinical guidelines into routine daily practice. Data show thatmany patients do not receive appropriate care, or receive unnecessary or harmful care. Many approaches claim to offersolutions to this problem; which ones are as yet the most effective and efficient is unclear. We aim to provide anoverview of present knowledge about initiatives to changing medical practice. Substantial evidence suggests that tochange behaviour is possible, but this change generally requires comprehensive approaches at different levels (doctor,team practice, hospital, wider environment), tailored to specific settings and target groups. Plans for change should bebased on characteristics of the evidence or guideline itself and barriers and facilitators to change. In general, evidenceshows that none of the approaches for transferring evidence to practice is superior to all changes in all situations.
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