An intermediate step in bridging the gap between evidence and practice: developing and applying a methodology for “general good practices”

The gap between evidence and clinical practice has been in the focus of researches for decades. Although successful implementation means the new knowledge must work in particular environments, it doesn’t mean that the entire process should exclusively be executed by the individual institutes. This is the point where we assumed that an intermediate step, the “general good practice”, could help to ensure that translation is done in a more professional way. The development of the general good practice methodology was based on our infinitE model, which organized the factors of successful translation into an evidence-editing-embedding-effect on practice framework, using tools from the disciplines of Evidence-Based Medicine, Quality Improvement and Change Management. The methodology organised the editing and embedding part of the development into a process involving three full-day sessions carried out with different health professionals, experts and moderators. After pilot testing, it was finalized and applied to other topics as well. The methodology presented in detail in this paper, centred on flow chart, process analysis, failure mode identification and Kotter’s 8-step model. Beside the pilot topic of the institutional process of resuscitation, the methodology has also proved applicable to more than ten other topics, meaning that at least all the core elements of the proposed bundle of general good practice have been produced in the development process. Compared to the guidelines, general good practices demonstrate the evidence in operation, helping to develop workflows, responsibilities, documentation, trainings, etc. and can also be a starting point for the digitalisation of care processes. The next step is to examine how healthcare institutions can build on these in their own editing and embedding activities, and what the results will be. Further studies could explore the applicability of the development methodology in different healthcare systems or at different levels of maturity in terms of quality. ### Competing Interest Statement I have read the journal’s policy and the authors of this manuscript have the following competing interest: Ã.B. is the President and J.L. is the Vice President of NEVES EgyesÃ1/4let, which is a non-profit patient safety organization in Hungary. ### Funding Statement Our research was carried out under the European Commission-funded EFOP-1.8.0-VEKOP-17-2017-00001, “Professional Methodological Development of the Healthcare System” project. All authors (HS, JL, IB, éB) and activities regarding the development and the related meetings were funded by this programme. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Not relevant, as our institution does not require ethical approval if patients are not involved in the research. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable Most relevant data are within the manuscript and its Supporting Information files. However, sources such as minutes, notes, working documents are available in Hungarian, contain sensitive data, can be confidential and are also part of the project administration. Requests for data access can made in writing to Semmelweis University Health Services Management Training Centre (info@emk.semmelweis.hu). Requests will be considered, and de-identified datasets will be prepared and made available electronically in Hungarian.