Wie gelangt Wissen in die Versorgung?

Implementierungsforschung und Wissenszirkulation

How does knowledge reach health care practice?

Implementation research and knowledge circulation

Zusammenfassung

Hintergrund

Evidenzbasiertes Wissen zählt zu den wichtigsten Ressourcen in der Gesundheitsversorgung. Relevantes Wissen wird jedoch oft nicht umgesetzt. Für diese „Wissen-Praxis-Lücke“ existieren rund 100 verschiedene Begriffe.

Fragestellung/Ziel

Vorgestellt werden die häufigsten Konzepte, die zur Beschreibung und Überwindung dieses Zustandes zur Anwendung kommen: die Implementierungsforschung und die Wissenstranslation oder Wissenszirkulation.

Material und Methoden

Initial erfolgte eine systematische Recherche in den Datenbanken Cinahl, Embase, ERIC, Medline, PsychInfo, Scopus, Cochrane Library und Web of Science ohne zeitliche oder sprachliche Einschränkungen. Aufgrund der Vielzahl der gefundenen Artikel und deren Heterogenität entschied sich das Autorenteam jedoch für eine Fokussierung und infolgedessen für eine narrative Übersicht.

Ergebnisse

Implementierungsforschung beschreibt die wissenschaftliche Untersuchung von Methoden, die systematisch die Übertragung aktueller Forschungsergebnisse und evidenzbasierter Praktiken in die Versorgung unterstützen und das Ziel verfolgen, die Qualität und Effektivität des Gesundheitssystems zu verbessern. Bereits aus dieser Definition wird die Nähe zur Versorgungsforschung deutlich. Wissenstranslation ist umfassender und schließt die Wissenssynthese mit ein. Besser erscheint der Begriff Wissenszirkulation, um den Charakter des Teilens von Wissen zwischen Wissenschaft und Praxis deutlich zu machen.

Diskussion

Implementierungsforschung und Wissenszirkulation sind ähnliche Forschungskonzepte, die versuchen auf der Mikro‑, Meso- und Makroebene des Gesundheitswesens Strategien zu entwickeln, um Wissen in die Praxis zu bringen. Hieraus ergeben sich meist komplexe Forschungsfragen, die interdisziplinär zu bearbeiten sind.

Abstract

Background

Evidence-based knowledge is among the most important resources in health care. However, relevant knowledge is often not implemented. There are about 100 different concepts for the “knowledge-to-practice gap”.

Objectives

We conducted this review to identify relevant concepts that describe and try to overcome this situation: implementation research and knowledge translation or circulation.

Materials and methods

We initially conducted a systematic search in the databases CINAHL, Embase, ERIC, Medline, PsycINFO, Scopus, Cochrane Library and Web of Science without time or language restrictions. Owing to the huge number of relevant articles and their heterogeneity, we decided to focus on the most important concepts thus perform a narrative review.

Results

Implementation research is the scientific study of methods of systematically promoting the uptake of current research findings and other evidence-based practices into routine practice, with the aim of improving the quality and effectiveness of health services. From this definition, the affinity with health services research seems to be clear. Knowledge translation has a wider spectrum and includes the synthesis of knowledge. The term “knowledge circulation” seems to fit better, because it underlines the sharing of knowledge between research and practice.

Conclusion

Implementation research and knowledge circulation are similar research approaches, which try to develop micro-, meso-, and macro-level strategies for health services to bring knowledge into practice. This results in often complex research questions, which should be processed in interdisciplinary teams.

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Danksagung

Die Autoren danken Karla Bergerhoff von der Düsseldorfer Cochrane Group für die Durchführung der systematischen Recherche. Weiterhin danken sie den Mitgliedern der Integrierten Arbeitsgruppe Wissenszirkulation und Implementierungsforschung der Universität Witten/Herdecke sowie den Mitarbeitern der gleichnamigen Arbeitsgruppe am Deutschen Zentrum für Neurodegenerative Erkrankungen (DZNE) für die fruchtbaren Diskussionen in den Jahren 2006–2012.

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Correspondence to Prof. Dr. Horst Christian Vollmar MPH.

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Interessenkonflikt

H.C. Vollmar, S. Santos, A. de Jong, G. Meyer und S. Wilm geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Vollmar, H.C., Santos, S., de Jong, A. et al. Wie gelangt Wissen in die Versorgung?. Bundesgesundheitsbl 60, 1139–1146 (2017). https://doi.org/10.1007/s00103-017-2612-z

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Schlüsselwörter

  • Implementierungsforschung
  • Wissenszirkulation
  • Wissenstranslation
  • Versorgungsforschung
  • Übersichtsarbeit

Keywords

  • Implementation research
  • Knowledge circulation
  • Knowledge translation
  • Health services research
  • Review