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Implementation Leadership in Evidence-Based Practice in Healthcare: A Systematic Review and Meta-Analysis
Suvi Kuha1,2, Jouko Miettunen3,4, Outi Kanste2,4,5
1Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
Worldviews on Evidence-Based Nursing
|August 11, 2026
Summary
This meta-analysis reveals that healthcare professionals and managers exhibit moderate levels of implementation leadership in evidence-based practice (EBP). Targeted leadership development is crucial to enhance supportive, knowledgeable, perseverant, and proactive behaviors, especially for managers.
Area of Science:
- Healthcare Management
- Organizational Behavior
- Evidence-Based Practice Implementation
Background:
- Evidence-based practice (EBP) is critical in healthcare, but its implementation faces challenges.
- Leadership significantly influences EBP implementation, yet quantitative data on leadership levels is scarce.
- Understanding implementation leadership is key to identifying development needs.
Purpose of the Study:
- To determine the pooled mean levels of implementation leadership in EBP among healthcare professionals and managers.
- To synthesize existing quantitative evidence on leadership in EBP implementation.
Main Methods:
- Systematic review and meta-analysis adhering to Joanna Briggs Institute methodology and PRISMA statement.
- Random-effects meta-analyses synthesized findings from 22 studies (9970 participants) published between 2014-2025.
- Searches conducted across multiple databases (MEDLINE, CINAHL, Scopus, etc.) with no date or geographical restrictions.
Main Results:
- The overall pooled mean implementation leadership level was 2.66 (95% CI: 2.49-2.83) on a 0-4 scale.
- Supportive leadership (3.00) and knowledgeable leadership (2.78) scored highest; proactive leadership (2.43) scored lowest.
- Managers (2.47) showed lower pooled means than professionals (2.70), with considerable heterogeneity observed.
Conclusions:
- Healthcare requires strengthened implementation leadership to effectively support EBP.
- Organizations should develop targeted leadership initiatives focusing on supportive, knowledgeable, perseverant, and proactive behaviors.
- Tailored leadership development is essential for managers, considering their unique roles and responsibilities.
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