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Implementation of Evidence-Based Practice and Organizational Performance

The Journal of Behavioral Health Services & Research volume 37, pages 79–94 (2010)Cite this article

Abstract

Administrators of mental health services may expect evidence-based practice (EBP) to offer strategic benefits. Existing theory suggests that the benefits of implementing EBP vary by organizational characteristics. This paper presents a conceptual framework for considering how implementation impacts organizational performance. The framework is developed as a system dynamics simulation model based on existing literature, organizational theory, and key informant interviews with mental health services administrators and clinical directors. Results from the simulations show how gains in performance depended on organizations’ initial inertia and initial efficiency and that only the most efficient organizations may see benefits in organizational performance from implementing EBP. Implications for administrators, policy makers, and services researchers are discussed.

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References

  1. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.

    Google Scholar 

  2. Drake B, Hovmand PS, Jonson-Reid M, et al. Adopting and teaching evidence-based practice in master’s level social work programs. Journal of Social Work Education. 2007;43(3):431–446.

    Article  Google Scholar 

  3. Hoagwood KE. The research, policy, and practice context for delivery of evidence-based mental health treatments for adolescents: A systems perspective. In: Evans D, Foa E, Gur R, Hedin H, eds. Treating and Preventing Adolescent Mental Health Disorders: What We Know and What We Don’t Know: A Research Agenda for Improving the Mental Health of Our Youth. New York: Oxford University Press; 2005:545–560.

    Google Scholar 

  4. Bartels SJ, Dums AR, Oxman TE, et al. Evidence-based practices in geriatric mental health care. Psychiatric Services. 2002;53(11):1419–1431, November 1, 2002.

    Article  PubMed  Google Scholar 

  5. Gonzales JJ, Ringeisen HL, Chambers DA. The tangled and thorny path of science to practice: tensions in interpreting and applying “evidence”. Clinical Psychology: Science and Practice. 2002;9(2):204–209.

    Article  Google Scholar 

  6. Rosen A. Knowledge use in direct practice. Social Service Review. 1994;68(4):561–577.

    Article  Google Scholar 

  7. Hoagwood K, Burns BJ, Kiser L, et al. Evidence-based practice in child and adolescent mental health services. Psychiatric Services. 2001;52(9):1179–1189.

    Article  CAS  PubMed  Google Scholar 

  8. Newman M, Papdopoulous I, Sigsworth J. Barriers to evidence-based practice. Intensive and Critical Care Nursing. 1998;14(5):231–238.

    Article  CAS  PubMed  Google Scholar 

  9. Rosenheck RA. Organizational process: a missing link between research and practice. Psychiatric Services. 2001;52(12):1607–1612.

    Article  CAS  PubMed  Google Scholar 

  10. Proctor E, Knudsen KJ, Fedoravicius NF, et al. Implementation of evidence-based practice in community behavioral health: agency director perspectives. Administration and Policy in Mental Health and Mental Health Services Research. 2007;34(5):479–488.

    Article  PubMed  Google Scholar 

  11. Klein KJ, Knight AP. Innovation implementation: overcoming the challenge. Current Directions in Psychological Science. 2005;14(5):243–246.

    Article  Google Scholar 

  12. Repenning NP. A simulation-based approach to understanding the dynamics of innovation implementation. Organization Science. 2002;13(2):109–127.

    Article  Google Scholar 

  13. Sastry MA. Problems and paradoxes in a model of punctuated organizational change. Administrative Science Quarterly. 1997;42(2):237–275.

    Article  Google Scholar 

  14. Pfeffer J, Salancik GR. The External Control of Organizations: A Resource Dependence Perspective. Stanford: Stanford University Press; 1978.

    Google Scholar 

  15. Scott WR, Meyer JW. The organization of societal sectors: propositions and early evidence. In: Powell WW, DiMaggio PJ, eds. The New Institutionalism in Organizational Analysis. Chicago: University of Chicago Press; 1991:108–140.

    Google Scholar 

  16. Powell WW. Expanding the scope of institutional analysis. In: Powell WW, DiMaggio PJ, eds. The New Institutionalism in Organizational Analysis. Chicago: The University of Chicago Press; 1991:183–203.

    Google Scholar 

  17. Ozcan YA, Shukla RK, Tyler LH. Organizational performance in the community mental health care system: the need fulfillment perspective. Organization Science. 1997;8(2):176–191.

    Article  Google Scholar 

  18. Ostroff C, Schmitt N. Configurations of organizational effectiveness and efficiency. The Academy of Management Journal. 1993;36(6):1345–1361.

    Article  Google Scholar 

  19. Meyer MW, Zucker LG. Permanently Failing Organizations. Newbury Park: Sage; 1989.

    Google Scholar 

  20. Zaltman , Duncan , Holbek . Innovations and Organizations. New York: Wiley; 1973.

    Google Scholar 

  21. Rogers EM. Diffusion of Innovation. 4th edn. New York: Free Press; 1995.

    Google Scholar 

  22. Hannan MT, Freeman J. Structural inertia and organizational change. American Sociological Review. 1984;49(2):149–164.

    Article  Google Scholar 

  23. Chinman M, Young AS, Hassell J, et al. Toward implementation of mental health consumer provider services. The Journal of Behavioral Health Services & Research. 2006;33(2):176–195.

    Article  Google Scholar 

  24. Deming WE. Out of the Crisis. Cambridge: Massachusetts Institute of Technology, Center for Advanced Engineering Study; 1986.

    Google Scholar 

  25. Forrester JW. Principles of Systems. Waltham: Pegasus Communications; 1971.

    Google Scholar 

  26. Sterman JD. Business dynamics: Systems Thinking and Modeling For a Complex World. New York: McGraw-Hill; 2000.

    Google Scholar 

  27. Levin G, Roberts EB. The Dynamics of Human Service Delivery. Cambridge: Ballinger; 1976.

    Google Scholar 

  28. Waldrop MM. Complexity: The Emerging Science at the Edge of Order and Chaos. New York: Simon & Schuster; 1992.

    Google Scholar 

  29. Harrison JR, Carroll GR. Culture and Demography in Organizations. Princeton: Princeton University Press; 2006.

    Google Scholar 

  30. Axelrod R. Advancing the art of simulation in the social sciences. Complexity. 1997;3:16–22.

    Article  Google Scholar 

  31. Office of Behavioral and Social Sciences Research. The Contributions of Behavioral and Social Sciences Research to Improving the Health of The Nation: A Prospectus for the Future. Washington, DC: U.S. Department of Health and Human Services; 2007.

    Google Scholar 

  32. Hovmand PS, Gillespie DF. Dynamics of Innovation Implementation in Social Service Organizations. Paper presented at International System Dynamics Conference, July 2006, Nijmegen, Netherlands.

  33. Tushman ML, Newman WH, Romanelli E. Convergence and upheaval: managing the unsteady pace of organizational evaluation. California Management Review. 1986;29(1):29–44.

    Google Scholar 

  34. Tushman ML, Romanelli E. Organizational evolution: a metamorphosis and model of convergence and reorientation. In: Cummings LL, Staw BM, eds. vol. 7, Research in Organizational Behavior. Vol 7. Greenwich: JAI; 1985:171–222.

    Google Scholar 

  35. Tushman ML, Virany B, Romanelli E. Executive succession, strategic reorientations, and organization evolution. Technology and Society. 1985;7:297–313.

    Article  Google Scholar 

  36. Samuel Y, Jacobsen C. A system dynamics model of planned organizational change. Computational and Mathematical Organization Theory. 1997;3(3):151–171.

    Article  Google Scholar 

  37. Hannan MT, Freeman J. The population ecology of organizations. The American Journal of Sociology. 1977;82(5):929–964.

    Article  Google Scholar 

  38. Romanelli E, Tushman ML. Organizational transformation as punctuated equilibrium: an empirical test. Academy of Management Journal. 1994;37:1141–1166.

    Article  Google Scholar 

  39. Burke C. Medicaid Funding For Nonprofit Heatlhcare Organizations. Washington, DC: The Aspen Institute; 2007.

    Google Scholar 

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Acknowledgements

We would like to thank the reviewers and Dr. Enola Proctor for their helpful comments. The key informant interviews were collected and analyzed in the Diffusion of Innovative Practices pilot study under the direction of Peter S. Hovmand and Enola Proctor. The pilot study and preparation of this manuscript were partially supported by the Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University; through an award from the National Institute of Mental Health (P30 MH068579). Continuation of this work is supported by the National Science Foundation (SES-0724577).

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Authors and Affiliations

  1. George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA

    Peter S. Hovmand PhD & David F. Gillespie PhD

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  1. Peter S. Hovmand PhD
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  2. David F. Gillespie PhD
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Correspondence to Peter S. Hovmand PhD.

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Hovmand, P.S., Gillespie, D.F. Implementation of Evidence-Based Practice and Organizational Performance. J Behav Health Serv Res 37, 79–94 (2010). https://doi.org/10.1007/s11414-008-9154-y

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Keywords

  • innovation implementation
  • evidence-based practice
  • organizational performance
  • mental health
  • system dynamics
  • simulation