It’s the Little Things that Matter: Implementation of Evidence-based Practice in Residential Aged Care

Considerable research has been undertaken in health care about implementing evidence-based practice but there has been little research in residential aged care. Thirteen projects were funded by the Australian Government to implement evidence-based practice in residential aged care, in nine different areas of practice. This study was undertaken to draw on the experiences of those involved in the program to identify the key mechanisms that influenced implementation. The methodology used grounded theory from a critical realist perspective, involving semi-structured interviews with 51 people in 44 interviews. Data analysis resulted in the development of a core category and three underlying mechanisms. The findings highlight the importance of having a ‘common ground’ on which implementation could take place; with a process of learning that connected people, knowledge and practice; within a context of reconciling competing priorities. Human agency, individually and collectively, was the final arbiter of whether changes were implemented.