Skip to main content

Table 1 Underlying study definitions

From: Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change

• Context/organizational context:
    Overall: The health care environment in which practice takes place and characterized by organizational culture, leadership, basic organizational components, and type of clinical setting.
    Pettigrew/Whipp[17]: An essential dimension or the WHY/motivation behind a strategic change to EBP.
Content: One of Pettigrew/Whipp's essential dimensions, in this case the WHAT of strategic change; i.e., organizational elements or processes in the system changed to enhance or support the use of evidence.
Evidence based practice (EBP): Practice derived from the best available evidence to achieve positive outcomes. This practice may range on a continuum from implementing a discrete practice (e.g. consistently using an evidence-based scale to assess the situation and implementing research-based interventions) to consistent ways or patterns of decision-making and practice (e.g. consistently seeking the best evidence in all decision-making to achieve positive outcomes).
Evidence: Knowledge derived from a variety of sources that has been subject to testing and has been found to be credible [67,68]. This includes:
    Research,
    Patient experiences and preferences, and
    Practical knowledge and local data (e.g. audit, quality assessments, planning and project data)
HOW of strategic change: See Process.
Implementation: Efforts designed to get evidence-based findings and related products into use via effective change interventions.
Infrastructure: Organizational structures, systems, roles, processes, relations, alignments, and capabilities.
Institutionalization: Integration of evidence-based practice into the routine fabric of the organization [10]; also known as normalization.
Intervention: Method or technique to enhance change.
Levels within the institution/institutional levels: Individual, group/team, organization, larger external system [38]. In this study, these levels refer to individual clinicians and leaders; EBP-related project teams or committees; clinical units; clusters of units within a service; department of nursing; hospital; and external health care-related environment.
Norm or Routine per EBP: Integrated into the everyday work of the clinical setting, in the policies, in the practices, in documentation, in the infrastructure, etc.
Normalization: It is the routine occurrence of EBP; see Institutionalization.
Process: One of Pettigrew/Whipp's essential dimensions [17], in this case the HOW of strategic change; i.e., the methods, strategies, or implementation interventions used to try to enable the use of evidence.
Research utilization (RU): The systematic process of transferring research knowledge into practice for the purpose of understanding, validating, enhancing or changing practice. RU consists of both the use of products of research and use of the research process [69].
Receptive context for change: "A combination of factors from both the inner and outer context that together determine an organization's ability to respond effectively and purposively to change. ... [p. 373, [11]." Per Pettigrew et al. [12].
Routine: See Norm or Institutionalization.
"Strategic": Refers to planned, organizational approaches to change and its deliberate management.
Sustainability: Changes (practice and outcomes) based on evidence that continue over time as related to specific projects.
WHAT of strategic change: See Content.
WHY of strategic change: See Context.