Toward More Effective Implementation of Evidence-Based Practice: Relational and Contextual Considerations

Largestudiesofhealthcaredeliverydemonstratethatonlyabouthalf(55%)ofU.S.citizensreceivenecessarycare;fewerthanhalfofphysicianpracticesuserecommendedprocessesofcare(McGlynnet al., 2003).Forexample,despitemanyyearsofevidencedemonstratingtheimportanceofhypertension treatment,only70%ofAmericanswithhypertensionarediagnosed,only60%aretreated,andonly

30% are controlled (Hajjar and Kotchen, 2003). Ÿis reflects a failure of the system to routinely provide effective, evidence-based delivery of care to the right patients at the right time.