Background
Methods
Stage 1: identifying the research question
Evidence
Innovation
Decision-making
Stage 2: defining the scope of the review
Stage 3: study selection
Stage 4: charting the data
Stage 5: reporting the results
Stage 6: stakeholder consultation
Results
Study characteristics
Professional level processes influencing evidence use
Preferences for evidence
Professional interests
Power dynamics
Organisational level processes influencing evidence use
Organisational roles
Organisational facilitators
Organisational barriers
Organisational politics
Local system level processes influencing evidence use
External pressures
Pan-regional organisations
Widening stakeholder involvement
Discussion
Summary
Themes | ||
---|---|---|
Professional level | Organisational level | Local system level |
Preferences for evidence | Organisational roles | External pressures |
• Varies by professional group and across health care sectors. | • Limit innovations where evidence lacking, assess finance and budgetary issues, and enable stakeholder involvement. | • Influenced how evidence was used in decision-making. |
Professional interests | Organisational facilitators | Pan-regional organisations |
• Influence professional groups’ preferences for innovations and responses to evidence. | • Being ‘data-driven’, well informed to take risks, strong leadership and structures for stakeholder involvement. | • Downward influence on evidence use in local decision-making. |
• Upward relationship whereby pan-regional organisations legitimised innovations/encourage disinvestment at organisational level | ||
Power dynamics | Organisational barriers | Widening stakeholder involvement: |
• Choice of evidence, its interpretation and use in adoption decisions negotiated. | • Time, resources and pressures; authority to implement change; centralised approach to decision-making. | • External networks enable wider range of potential stakeholders to inform decision-making. |
Organisational politics | ||
• Shapes selection and interpretation of evidence. |