A roadmap for organization-wide implementation of evidence-based medicine: an overview of reviews.

AIMS: The aim of this overview is to provide a roadmap for the organization-wide implementation of evidence-based medicine (EBM) by synthesizing evidence across three key implementation process steps: outcome measurement, contextual analysis, and strategy selection. METHODS: A systematic overview of reviews was conducted following an a priori protocol (osf.io/65zn2). Reviews that provided information on EBM implementation, published from 2013 to 2023, were retrieved from MEDLINE (Ovid), Embase (Ovid), and CINAHL (EBSCOhost). An implementation process model, a conceptual framework for organizational readiness, and a taxonomy for implementation strategies were used to synthesize the findings. RESULTS: The overview screened 8,726 reviews, of which 100 were included. Reviews related to outcome measurement (n = 50) all reported provider-level outcomes (e.g., knowledge and skills) and identified up to 204 instruments. Four instruments were consistently recommended: EBPQ, EPIC, Fresno Test, and HS-EBP. The results of reviews on contextual analysis (n = 57) were structured according to five Organizational Readiness concepts and 22 themes. Organizational (n = 51) and personal factors influencing EBM implementation (n = 48) were discussed most. Reviews reporting implementation strategies (n = 40) mainly investigated educational strategies (n = 38). Other strategies, such as infrastructure changes, were less commonly evaluated. CONCLUSIONS: This overview of reviews identifies actionable insights for the organization-wide implementation of EBM, including validated provider-level measurement instruments, a comprehensive overview of contextual factors, and effective strategies to support implementation. Critical evidence gaps concerned non-educational strategies as well as the assessment of organizational and patient-level outcomes. By connecting insights across all stages of the implementation process, our synthesis offers health care organizations a structured roadmap to design, implement, and evaluate sustainable EBM initiatives. SPANISH ABSTRACT: https://links.lww.com/IJEBH/A692.