Facilitating evidence-based practice: frequency analysis of audit, feedback, and implementation strategies across Taiwan.

BACKGROUND

Audit and feedback are established strategies for improving clinical practice, yet evidence gaps remain regarding the mechanisms that link feedback to behavior change.

AIM: This study examined implementation projects conducted in Taiwan that used the JBI Model of Evidence-based Healthcare and the JBI 7-phase implementation process framework. The objective was to identify common barriers, enablers, and strategies across diverse health care settings.

METHODS

Fifteen Taiwanese implementation studies (2020-2025) were included and evaluated using frequency analysis and central tendency measures. Data extraction was piloted and papers were then coded for audit criteria, barriers, enablers, and implementation strategies, with reference to underlying theories, models, and frameworks.

RESULTS

Across studies, projects were nurse-led and multidisciplinary, with most applying combined internal-external facilitation models. Process-based audit criteria predominated. Multi-modal implementation strategies aligned with the COM-B behavior change model were frequent, with more enablers than barriers reported. All projects used at least one theory, model, or framework-most commonly the JBI Model of Evidence-based Healthcare and the JBI 7-phase implementation process framework. Improvements in compliance were consistently observed but varied by topic and context.

CONCLUSIONS AND RELEVANCE TO TAIWAN: Successful implementation depended on structured facilitation, leadership engagement, and active team participation. Key challenges reflected organizational hierarchy, communication patterns, and workload. Embedding structured audit and feedback cycles within institutional governance and professional education could strengthen evidence-informed practice nationwide. Future work will develop a culturally attuned implementation toolbox to guide sustained, system-wide improvement in Taiwan.

SPANISH ABSTRACT: https://links.lww.com/IJEBH/A665.