Retention of best practices by clinicians after knowledge transfer

Abstract

This thesis examines the retention of best practices by clinicians after the implementation of an integrated care pathway for patients with congestive heart failure. While the literature suggests there are many reasons why the implementation of best practices is difficult, there is little information on the sustainability of best practices once implemented.Using a qualitative research design guided by Rogers’ theory of ‘Diffusion of Innovations’ the researcher interviewed seven clinicians who participated in the implementation of the pathway. A thematic analysis revealed several themes that ran throughout participants’ responses. While the participants indicated they see value in best practices, they also identified barriers to getting that knowledge into practice and keeping it there. A spectrum of factors, including individual autonomy, time, resources, organizational support and the organization of the system all played a role.In the end, participants revealed that although small pieces of the pathway remain in practice, the pathway itself is no longer used by clinicians to manage patients with congestive heart failure.