Grant: Travel Awards - Institute Community Support

The healthcare sector is supported by a very well-developed research base both in the clinical and basic sciences. However, compared to other sectors healthcare is a laggard when it comes to using new evidence to change existing clinical practices. What this means is that your physician, nurse, or other health care provider is often making decisions about diagnosis and treatment on outdated evidence. Knowledge translation research aims to bridge the gap between new evidence and changes to practice. Most of the research in knowledge translation has focused on understanding how healthcare organizations adopt and implement new or changed practices. But just because a new practice has been adopted and implemented does not necessarily mean that it will continue to be used or that it will continue to produce positive outcomes for patients. Many promising new initiatives are implemented, only to be lost and forgotten. There are comparatively few studies examining the sustainability of evidence-based practice changes and our understanding of the sustainability of changes to health care practice is at an early stage. A vast array of organizational factors - everything from leadership to the political environment - has been linked to sustainability in various studies. Although other researchers have catalogued the different factors linked to sustainability in the literature, no one has critically examined the methods used to identify these factors, the relative importance of the various factors, or the relationships between factors. This study seeks to address that gap by performing a critical review of the determinants of sustainability in the literature and by organizing and mapping those factors using organizational learning theory. The resulting concept map serves as a useful guide to help practitioners design long-term, sustainable changes to practice and provides a series of testable propositions that will guide future research in this field.