A bootstrap approach to implementation science

A troubling gap exists between scientific breakthroughs and clinical practice. New discoveries and evidence-based guidelines are typically slow to fully penetrate all levels of health care delivery. The long-standing assumption that interventions tested in randomized clinical trials (RCTs) will disseminate into day-to-day practice is largely incorrect; only 14% of new scientific information becomes part of widespread clinical practice within 17 years after its discovery.1,2 Even where evidence-based guidelines are available, they are often underused in primary care.

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