A practical framework to improve evidence-based practice adoption

Effective implementation of evidence-based practices (EBPs) can enhance care delivery, increase efficiency, optimize spending and improve patient outcomes. Yet, only one in five EBPs achieve routine use, and they can take years to implement.^1,2,3

Standardized processes, such as new or enhanced treatments, tools, programs and practices, exist to support EBP adoption, but uptake remains challenging. For example, adopting a standardized treatment escalation protocol for managing disease flares can promote more consistent, guideline-concordant care, yet may face challenges related to provider awareness, workflow integration and cross-disciplinary alignment. If not addressed, these barriers can make adoption inefficient, timeconsuming and costly, and efforts to address them are often reactive rather than proactive.

No one-size-fits-all solution exists to close the adoption gap. However, implementation science is a proven approach for promoting the adoption of EBPs into routine care using scientific discipline and multi-stakeholder collaboration to identify solutions. Central to this approach is the use of structured frameworks to systematically assess barriers, guide strategy selection and evaluate impact. By translating barriers into actionable strategies, implementation science drives faster, more effective EBP adoption.⁴

Using a structured approach

Implementation science is a structured, systematic process for understanding the factors that inhibit or support the uptake of EBPs in practice.

This process is most effective when it’s supported by a culture that recognizes the value of adopting new practices to improve patient outcomes. A strong predictor of successful implementation is a supportive organizational culture that encourages evaluation of current practices and prioritizes continuous improvement and is more willing to identify gaps, embrace change and champion new approaches.

While implementation strategies will vary, organizations can use a core set of approaches to move from identifying barriers to systematically addressing them.

Contextualization: Understand the environment

Understanding the context in which a new EBP will be deployed can help organizations address factors like stakeholder needs and behaviors that influence adoption. Organizations can conduct contextualization research, which links context with action.

Contextualization research isn’t rigidly prescribed. Organizations can employ a mix of study methods to identify barriers, such as resistance to changing established practices, as well as enablers that support uptake. This could be a combination of patient interviews and surveys of staff where the new EBP will be implemented to uncover the factors that may support or hinder adoption.

Establishing a guiding framework to organize and interpret insights from this research enables them to inform implementation strategy.

Design and testing: Focus on what matters

Once contextual factors are understood, organizations can create a well-defined implementation strategy. A key component is the structured design and testing of interventions and the strategies supporting them.

Given the complexity of many healthcare interventions, identifying what is most important to test and measure can be difficult. Establishing clarity and consensus around priorities enables more effective decision-making and helps ensure focused evaluation. Identifying a set of key metrics and limiting measurement to those that matter most allows organizations to monitor progress while supporting sustained implementation.

Insights generated from testing can be used to refine implementation strategies, inform future efforts and support long-term sustainability and scalability. They should be incorporated into the guiding framework.

Deployment: Adapt and monitor

Another key component of a well-defined strategy is ongoing monitoring of interventions after deployment. This can help organizations identify where adaptations may be needed and support decision-making around how best to implement changes.

Some elements of an intervention, such as education and training, can be adapted to fit the current context. Others must remain unchanged, such as when specific equipment must be used or when technical requirements are needed to ensure patient safety and efficacy. In these cases, alternative approaches may be required to address implementation challenges.

A guiding framework plays an important role in this phase as well by tracking adaptations and assessing their impact on implementation goals. This enables organizations to understand what is working, where adjustments are needed and how the implementation program aligns with broader organizational objectives.

Implementation science in action

The case of one healthcare organization facing challenges in introducing a new treatment demonstrates how implementation science can enhance the delivery of healthcare advances.

After a cardiovascular product was integrated into a hospital system’s electronic health record (EHR), prescribers faced several challenges that limited its routine use. Errors in order sets caused confusion at the point of prescribing, while inconsistent dosing across indications and misalignment with comparable therapies disrupted established workflows.

A structured review of the prescribing environment identified the causes of the challenges. Findings were shared with institutional clinical decision-makers, enabling targeted updates to order sets and prescribing processes.

Addressing these issues helped reduce barriers to adoption and improve the efficiency of care delivery. As workflow gaps were identified and resolved, the organization saw measurable improvements, including a 38% reduction in hospital system errors compared to the previous year.

Sustaining adoption

Closing the evidence-to-practice gap requires not only strong clinical data but also organizations that support and can effectively implement change.

A structured approach grounded in implementation science and supported by a culture that values continuous improvement can enable organizations to identify barriers, align stakeholders and sustain new practices over time. By doing so, organizations can improve the likelihood that advances in care achieve their intended impact, benefiting patients, physicians and other healthcare stakeholders.

1. Balas EA, Weingarten S, Garb CT, Blumenthal D, Boren SA, Brown GD. Improving Preventive Care by Prompting Physicians. Arch Intern Med. 2000 Feb 14;160(3):301-8. doi: 10.1001/archinte.160.3.301.
2. Morris ZS, Wooding S, Grant J. The Answer is 17 Years, What is the Question: Understanding Time Lags in Translational Research. J R Soc Med. 2011 Dec;104(12):510-20. doi: 10.1258/jrsm.2011.110180.
3. Reis SE, McDonald MC, Byers SJ. Crossing the Research Valleys of Death: The University of Pittsburgh Approach. Clinical and translational science. 2008 May;1(1):9.
4. Foster S, Hill J. Implementation Science: The Art of Intended Consequences. IQVIA. 2025.

Jennifer N. Hill, M.S., is director of scientific services, patient centered solutions at IQVIA.