Translating healthcare research evidence into practice: The role of linked boundary objects

Recent years have seen widespread interest in the process of evidence implementation and growth of implementation science. Whilst this work has drawn attention to the challenges and complexities of implementing evidence into everyday practice, for the most part, studies of implementation uphold the ideal of a linear 'pipeline' between research and front-line care. In contrast, this paper adopts a practice perspective on knowledge, and draws on science and technology studies concepts to identify how the socio-material environment contributes to the translation of evidence across multiple organisational and professional boundaries. Findings report on a qualitative case study of implementing fall prevention research evidence at a large teaching hospital in Portugal. Data is from forty-six in-depth semi-structured interviews with clinical and non-clinical staff. The case highlights how linked boundary objects bridge temporally sequential boundaries between research and different practice communities, hence facilitating the translation of research evidence into everyday practice. The initial boundary object (the 'Morse' fall risk assessment scale) contributed to evidence being taken up by specialist nurses within the hospital, while a second boundary object (a pink patient wristband) engendered a change in practice of a wider network of actors. Nevertheless, the symbolic connection between the two linked boundary objects remained precarious, dependent on networks of interaction and communication. The study highlights the role of material objects in the ongoing translation of research evidence into everyday clinical practice.