'Closing the loop': the role of health care leaders in integrating research and practice.

The study reported here examines what health care leaders do to implement the routine integration of information into clinical practice decision making. Clinical leaders of a major Australian tertiary teaching hospital were interviewed. The study found that there is wide variation in the extent to which information is routinely used to inform practice. Those leaders who successfully integrated information used some common strategies. The ownership of information may be the single most powerful factor in clinical leaders' ability to encourage its use. A lack of trust, inappropriate systems and a fear of unfavourable consequences were identified as issues. The findings have implications for policy makers, hospital administrators and clinical leaders and question the effectiveness of centralised approaches to driving clinical change.