Knowledge to Action? Evidence-Based Health Care in Context

Health services can and should be improved by applying research findings about best practice. This book explores why it proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures. It draws on a large body of evidence acquired in the course of nearly fifty case studies using data from 1,400 interviews with doctors, nurses, and managers, as well as observations and documentary analysis. Using qualitative methods to study hospital and primary care settings, the book aims to shed light on why attempts to introduce evidence-based practice in the UK NHS succeeded in some cases where in others it faltered. By opening up the intricacies and complexities of change in the NHS, it reveals the limitations of simplistic approaches to implementing research or introducing evidence-based health care. The book provides an analysis rooted in a range of theoretical perspectives that underlines the intimate links between organizational structures and cultures and the utilization of knowledge, and draws conclusions significant for other areas of public management. The findings have implications for the utilization of knowledge in situations where there is a professional tradition working within a politically sensitive blend of public service, managerial accountability, and technical expertise.