Volume 75, Issue 4 pp. 363-371
Health Services Evaluation

Process of knowledge translation within routine clinical care: Implementing best practice in weight management

Shelley A. Wilkinson

Corresponding Author

Shelley A. Wilkinson

Department of Nutrition & Dietetics, Mater Health Services, Brisbane, Queensland, Australia

Mater Research Institute, University of Queensland, South Brisbane, Brisbane, Queensland, Australia

Correspondence: S.A. Wilkinson, Department of Nutrition and Dietetics, Level 3, Salmon Building, Mater Health Services, Raymond Terrace, South Brisbane, QLD 4101. Tel: +61 7 3163 6000; fax: +61 7 3163 2442.

Email: [email protected]

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Elyssa Hughes

Elyssa Hughes

Department of Nutrition & Dietetics, Mater Health Services, Brisbane, Queensland, Australia

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Jessica Moir

Jessica Moir

Department of Nutrition & Dietetics, Mater Health Services, Brisbane, Queensland, Australia

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Chloe Jobber

Chloe Jobber

Department of Nutrition & Dietetics, Mater Health Services, Brisbane, Queensland, Australia

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Antoinette Ackerie

Antoinette Ackerie

Department of Nutrition & Dietetics, Mater Health Services, Brisbane, Queensland, Australia

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First published: 21 September 2018
Citations: 3
S.A. Wilkinson, PhD, AdvAPD, Senior Maternal Health Research Dietitian & Health Research Fellow
E. Hughes, BND, APD, New Graduate Dietitian
J. Moir, BHSc(Nut & Diet), APD, (former) Dietitian
C. Jobber, MND, APD, Clinical Educator Dietitian
A. Ackerie, BHSc(Nut & Diet), APD, Team Leader

Abstract

Aim

Failure to translate research into practice is common. The present study implemented an evidence-based model of care to address identified evidence-practice gaps in our department's weight management service.

Methods

Implementation science frameworks were used to identify barriers to best practice and determine appropriate strategies to overcome them. No practice change occurred pre-implementation. The new model of care incorporated evidence-based interventions into a flowchart, supported by written resources, and integrated routine data collection into clinic processes. Alignment with a statewide telephone counselling program enhanced service capacity. Data were collected for adult patients whose primary intervention was weight management at a South-East Queensland hospital and included service attendance metrics, anthropometry, diet quality, and interventions delivered, and were compared with guidelines. Change in outcomes was calculated at 3 months after initial appointments.

Results

Pre-implementation, 69.2% (n = 91) of patients referred were seen by a dietitian. During the new model of care (n = 60), over half (63.3%) were referred to telephone counselling. The remainder were triaged according to the flowchart with 100% attendance. Guideline adherence for reviews significantly increased over time (4.4%–50%, P < 0.001). Follow-up data were available for 31.3% and 54.5% of the pre-implementation and new model of care patients, respectively. No significant differences were observed between outcomes.

Conclusions

The present study demonstrated successful implementation of weight management guidelines within routine clinical care. Following a systematic assessment of existing evidence-practice gaps resulted in a pragmatic evidence-based model of care that could be delivered within service capacity.

Conflict of interest

The authors have no conflicts of interest to declare.

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