Ingredients for change: revisiting a conceptual framework

Finding ways to deliver care based on the best possible
evidence remains an ongoing challenge. Further
theoretical developments of a conceptual framework are
presented which influence the uptake of evidence into
practice. A concept analysis has been conducted on the
key elements of the framework—evidence, context, and
facilitation—leading to refinement of the framework.
While these three essential elements remain key to the
process of implementation, changes have been made to
their constituent sub-elements, enabling the detail of the
framework to be revised. The concept analysis has
shown that the relationship between the elements and
sub-elements and their relative importance need to be
better understood when implementing evidence based
practice. Increased understanding of these relationships
would help staff to plan more effective change
strategies. Anecdotal reports suggest that the framework
has a good level of validity. It is planned to develop it
into a practical tool to aid those involved in planning,
implementing, and evaluating the impact of changes in
health care.
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