From Research Evidence to "Evidence by Proxy"? Organizational Enactment of Evidence-Based Health Care in Four High-Income Countries

Roman Kislov, Paul M. Wilson, Greta G. Cummings, Anna C. Ehrenberg, Wendy A. Gifford, Janet Kelly, A. L. Kitson, Lena Pettersson, Lars Wallin, Gillian Harvey

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3 Citations (Scopus)

Abstract

Drawing on multiple qualitative case studies of evidence-based health care conducted in Sweden, Canada, Australia, and the United Kingdom, the authors systematically explore the composition, circulation, and role of codified knowledge deployed in the organizational enactment of evidence-based practice. The article describes the “chain of codified knowledge,” which reflects the institutionalization of evidence-based practice as organizational business as usual, and shows that it is dominated by performance standards, policies and procedures, and locally collected (improvement and audit) data. These interconnected forms of “evidence by proxy,” which are informed by research partly or indirectly, enable simplification, selective reinforcement, and contextualization of scientific knowledge. The analysis reveals the dual effects of this codification dynamic on evidence-based practice and highlights the influence of macro-level ideological, historical, and technological factors on the composition and circulation of codified knowledge in the organizational enactment of evidence-based health care in different countries.

Original languageEnglish
Pages (from-to)684-698
Number of pages15
JournalPublic Administration Review
Volume79
Issue number5
DOIs
Publication statusPublished - 30 Apr 2019

Bibliographical note

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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    Kislov, R., Wilson, P. M., Cummings, G. G., Ehrenberg, A. C., Gifford, W. A., Kelly, J., Kitson, A. L., Pettersson, L., Wallin, L., & Harvey, G. (2019). From Research Evidence to "Evidence by Proxy"? Organizational Enactment of Evidence-Based Health Care in Four High-Income Countries. Public Administration Review, 79(5), 684-698. https://doi.org/10.1111/puar.13056