Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation

Annu Rev Public Health. 2014;35:255-74. doi: 10.1146/annurev-publhealth-032013-182447.


There has been a growing impetus to bridge the gap between basic science discovery, development of evidence-based practices (EBPs), and the availability and delivery of EBPs in order to improve the public health impact of such practices. To capitalize on factors that support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups. Leaders play a key role in determining the nature of system and organizational contexts. This article addresses the role of leadership and actions that leaders can take at and across levels in developing a strategic climate for EBP implementation within the outer (i.e., system) and inner (i.e., organization, work group) contexts of health care. Within the framework of Edgar Schein's "climate embedding mechanisms," we describe strategies that leaders at the system, organization, and work group levels can consider and apply to develop strategic climates that support the implementation and sustainment of EBP in health care and allied health care settings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Evidence-Based Practice / organization & administration*
  • Health Services Research / organization & administration*
  • Humans
  • Leadership*
  • Motivation
  • Organizational Culture*
  • Personnel Management
  • Public Health
  • Resource Allocation
  • Translational Medical Research / organization & administration*