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Getting evidence into practice—implementation science for paediatricians
  1. Mitch Blair
  1. Correspondence to Professor Mitch Blair, Paediatrics and Child Public Health, River Island Academic Centre for Paediatrics and Child Health, Northwick Park Hospital, Harrow, Middlesex, HA1 3UJ, UK; m.blair{at}imperial.ac.uk

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Summary

It is estimated that on average it takes 17 years to get research findings used in day to day practice. Nearly two million scientific articles are published every year. There is a knowledge-practice gap which requires closing if we are to make optimum and timely use of the best evidence to inform and change our clinical practice. This article explores the theoretical background to knowledge translation and knowledge discovery and gives child health examples of how diffusion and dissemination of knowledge occurs in practice. It is suggested that there is a unique role for knowledge brokers in paediatrics to facilitate change and outlines how various barriers to change might be overcome.

Introduction

We know more than we think about what improves children's health status. As readers of this and other journals will be only too aware, for virtually every research paper that is published, there is a sentence exhorting calls for more research. However, there is a substantial ‘know-do’ gap which exists between what we know already and how we implement it in practice to support our patients care. This gap has grown considerably with the exponential rise in new research findings being published every year. There were about 28 100 active scholarly peer-reviewed journals in August 2012, collectively publishing about 1.7–1.8 million articles a year.1 It is clear that it would be impossible for a practitioner to be able to read let alone use this new knowledge in day to day practice. One can appreciate why it might take some time for this to filter through to us. The following section gives two examples of how findings from basic science research took many years to be used in routine clinical practice.

The first of these was the introduction of antenatal steroids in late pregnancy threatened by premature delivery to avoid …

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