Closing the gap between what we know and what we do in palliative care

Health services and systems look at how to ensure that the care being provided is consistent with evidence for best practice. [1] There is a growing recognition of gaps between what is known from research evidence and actual clinical practice and barriers to the use of evidence. [2] By reducing these gaps we can look at improving healthcare and health outcomes.

Moving evidence into use and reducing evidence-practice gaps is a complex task that requires input from many different groups including researchers, clinicians, consumers and policy makers. The National Institute of Clinical Studies is an institute of the National Health and Medical Research Council with a specific focus on how to improve healthcare by closing gaps between the best available evidence and real world practice.

For palliative care, as for other disciplines, reducing evidence-practice gaps presumes the existence of relevant evidence. This forms the base against which current practice is assessed and change programs are initiated if needed. Within palliative care, the literature is beginning to report about implementation and moving evidence into practice. [3-7]

  1. World Health Organization. Bridging the “Know–Do” gap: Meeting on knowledge translation in global health 10-12 October 2005. Geneva: World Health Organization; 2006. (2.21MB pdf)
  2. Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof. 2007 Spring;27(2):94-102.
  3. Schuman ZD, Abrahm JL. Implementing institutional change: an institutional case study of palliative sedation. J Palliat Med. 2005 Jun;8(3):666-76.
  4. Watson J, Hockley J, Dewar B. Barriers to implementing an integrated care pathway for the last days of life in nursing homes. Int J Palliat Nurs. 2006 May;12(5):234-40.
  5. McGuire DB. Barriers and strategies in implementation of oral care standards for cancer patients. Support Care Cancer. 2003 Jul;11(7):435-41. Epub 2003 Apr 12.
  6. Flemming K, Adamson J, Atkin K. Improving the effectiveness of interventions in palliative care: the potential role of qualitative research in enhancing evidence from randomized controlled trials. Palliat Med. 2008 Mar;22(2):123-31.
  7. Elwyn G, Taubert M, Kowalczuk J. Sticky knowledge: a possible model for investigating implementation in healthcare contexts. Implement Sci. 2007 Dec 20;2:44.

Last updated 24 August 2021