最佳实践聚焦组织模式:一种综合的指南实施方法论OA

Sustained integration of evidence-based clinical practice guidelines into routine practice and education remains inconsistent across health systems.While implementation science offers robust theoretical explanations of determinants of success,published reports often under-specify how theory is oper-ationalized through governance,knowledge mobilization,and measurement systems that support accountability and learning over time.This limits interpretability,replication,and cumulative learning across contexts.This paper presents the Best Practice Spotlight Organization®(BPSO®)Model,an in-tegrated guideline implementation methodology designed to address this gap.The model specifies a system-level implementation architecture that integrates four core elements:1)action frameworks(Knowledge-to-Action and Social Movement Action),2)governance and accountability,3)knowledge mobilization,and 4)measurement and evaluation.Governance,knowledge mobilization,and mea-surement function as cross-cutting mechanisms across all phases to stabilize implementation effort,sustain engagement,and embed learning.The model is enacted through five iterative yet sequential phases:organizational readiness and preparation;planning and local adaptation;implementation and integration into practice;monitoring,evaluation,and outcomes;and sustainability and spread.Although the methodology originated within the Registered Nurses' Association of Ontario's(RNAO's)guideline implementation work,it is not dependent on RNAO-specific programs,tools,or data systems.Instead,the paper defines minimum functional requirements to support transferability across clinical,academic,and system contexts.The model is proportionate and adaptable across high-and low-resource environments,interprofessional settings,and digitally enabled systems.Grounded in over two decades of implementation experience and supported by a large body of multi-site and interna-tional evaluations,this paper focuses on specifying the methodological architecture that underpins sustained change.By making implementation logic explicit,the BPSO® Model offers a transferable and scalable approach to advancing evidence-based practice and supports more interpretable,cumulative learning across settings.