From clinical guidelines to clinical care -- employee involvement makes
a positive difference to implementation.
Abstract
Objectives Implementation of new knowledge into routine care is a
complex endeavour. Involving employees in the change process, good
planning and communication as well as a commitment to training has been
highlighted as important factors for successful implementation.
Acknowledging change as a process may also be helpful. The aim of this
paper was to describe the initial phase of the implementation process in
changing to evidence-based practisepractices within a child and
adolescent mental health service. Method Prior to the five-year project,
an external service evaluation was carried out. The employees expressed
a need for a clear direction from management to guide their clinical
practice. A vision and strategy for the service was developed. Employees
participated in the process of developing clinical standards during the
first phase of implementation. Results Fixsen’s four stage model and the
PSDA circle were used to guide the implementation process. The employees
developed a template for a clinical standard based on national and
international clinical guidelines. During the period, 17 clinical
standards were established and 10 new evidence-based methods were
implemented. All service leads (13) and a group of senior clinicians
(32) were invited to participate in an evaluation five years after the
initial service evaluation. There was overall agreement that the mental
health service was developing positively providing high quality services
for children and adolescents. In addition, both groups agreed that the
introduction of clinical standards was important in ensuring quality
care. Conclusion Involving employees in the implementation process
seemed to be an important factor in changing a mental health service.