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Johns Hopkins Nursing Evidence-Based Practice

A companion guide for Johns Hopkins Nursing Evidence-Based Practice at Upstate

Step 12: Determine fit and feasibility of recommendations for translation plan

Fit and feasibility

Even when evidence is strong and of high quality, it may not be appropriate to implement a change in practice. It is crucial to examine feasibility that considers the resources available, the readiness for change, and the balance between risk and benefit. Fit refers to the compatibility of the proposed change with the organization’s mission, goals, objectives, and priorities. A change that does not fit within the organizational priorities will be less likely to receive leadership and financial support, making success difficult. Implementing processes with a low likelihood of success wastes valuable time and resources on efforts that produce negligible benefits.

Step 13: Create action plan

When creating an action plan consider the following: 

  • How will the change be accomplished?
  • What is the timeframe?
  • Identify barriers to success.
  • Identify strengths that can be leveraged to overcome barriers.
  • Is there support and/or availability of funds to cover expenses?
  • How will the change impact workflows and processes?
  • What are the steps for implementing the action plan? Who is responsible for implementing each step?
  • Identify observable pre and post measures.
  • Identify critical milestones.

Appendix I: The Action Planning Tool ensures that you have a team in place to help you champion and implement change. Find Appendix I here.

Step 14: Secure support and resources to implement action plan

Securing support is critical to the implementation of an action plan. Consider that support can be human, material, financial, and/or technological. Endorsement of stakeholders, such as organizational leaders, committees, and/or those individuals or groups affected by the action plan, is critical to the allocation of support. 

Prepare a presentation for decision-makers and stakeholders in order to build organizational support. 

Estimation of dissemination costs, such as travel and other costs associated with presentation or poster development should be discussed during this step. 

Step 15: Implement action plan

The Four P's of Implementing an Action Plan:

  1. Purpose - Explain why things are changing
  2. Picture - Give those affected time to process how the change will impact their work, and time to discuss that impact
  3. Plan - Implement the plan step by step
  4. Participation - Built momentum with dynamic, positive, and consistent engagement of the stakeholders and affected teams

Step 16: Evaluate outcomes

When evaluating outcomes, keep these four elements in mind:

  • When possible, use validated tools to evaluate the effectiveness of change
  • Discuss outcomes with stakeholders (and pilot group if used)
  • Consider making adjustments as needed
  • Change takes time, give your action plan enough time to be successful

Step 17: Report outcomes to stakeholders

After the outcome evaluation, the team must report findings to stakeholders and organizational leadership. Consider tailoring the key message to the needs and interests of each group.

Rules for communication about change and transition- the whole truth is better than just good news, face to face communication is better than electronic communication, listening is better than talking, understanding is better than agreeing, and walking the walk is better than talking the talk

Step 18: Identify next steps

Consider the following question when identifying your next steps:

  • Can this practice change be implemented on other units or system-wide?
  • Does the action plan need to be modified for larger scale implementation?
  • Do you need to engage additional stakeholders?
  • Should team responsibilities be reassigned?
  • Is additional education or training necessary? 

Step 19: Disseminate findings

Findings can be disseminated both internally and externally

Strategies for internal dissemination can include:

  • Grand rounds
  • Newsletters
  • Intranet postings
  • Shared governance meetings
  • Lunch and Learn meetings

Strategies for external dissemination can include:

  • Poster presentations
  • Podium/Conference presentations
  • Publication

The Dissemination Tool guides you through ways you can disseminate your findings at conferences, in publications, in social media, and more. Please find Appendix J here

This guide was created by adapting materials from The Johns Hopkins Nursing Center for Evidence-Based Practice.