Assumptions
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Organization must be committed
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Visible, potent, enduring mechanisms vital
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Substantial resources necessary
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Planned change is essential
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Two or more studies are required to support change
Steps
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Systematic problem identification
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Assessment of research
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Adaptation/design of practice innovation
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Conduct of clinical trial and evaluation
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Decision: adoption, modification, rejection
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Plan for diffusion of innovation
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Mechanisms for maintenance
Criteria
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Evaluating and integrating studies for the research base
- Replication (at least two studies)
- Scientific merit
- Risk