Injury Management Resources

The Process of Implementing Evidence in Practice

1). Demonstrating an evidence-practice gap

Often there is a ‘gap’ between what is known and what is done in practice. This evidence-practice gap may relate to testing procedures, assessments, or delivery of a therapy.

A new testing procedure may be more accurate or sensitive than the one(s) in current use. Or a therapy may be more effective than the therapy currently provided. In some instances, a test or therapy is being underused. In other instances, the test or therapy may be overused. In both instances, changes in practice are required.

First, you will need to decide what evidence-based assessment or intervention is being underused (or overused) in your work area. Next, collect some simple baseline data. You need to demonstrate a gap between what is known and what is being done locally, using techniques such as a survey, interviews with staff or clients, a focus group with staff or clients, or a medical record audit.

One example of implementing evidence in practice has been published by Kramer and Burns (2008) who implemented cognitive behavioural therapy in two mental health centres in the US (Kramer & Burns, 2008). The authors noted that CBT was being underused. Using survey methods, they found that two thirds of practitioners reported having no formal training in cognitive behavioural therapy, and no prior experience using a treatment manual for cognitive behavioural therapy. They identified an evidence-practice gap. Furthermore, almost half of the participants in that study reported that they never or rarely used evidence-based treatments for youths with depression, and a quarter of the group had no plans to use evidence-based treatment in the following six months. Subsequently, that group of mental health professionals was targeted with an implementation program to increase the uptake of the underused cognitive behavioural therapy


Kramer T, & Burns B. (2008). Implementing cognitive behavioural therapy in the real world: A case study of two mental health centres. Implementation Science;3:14.


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