Psychiatr Q (2006) 77:309–318
Lessons Learned in Implementing Evidence-Based
Practices: Implications for Psychiatric Administrators
Richard M. Bloch, Ph.D. · Sy Atezaz Saeed, M.D. ·
Jeanne C. Rivard, Ph.D. · Christina Rausch, M.S.W.
Published online: 22 August 2006
Springer Science+Business Media, Inc. 2006
Abstract Factors related to the dissemination and implementation of evidence-based prac-
tices (EBPs) are discussed. Extensive effort is required to successfully implement and sustain
EBPs that improve clinical outcomes. There is a rapid rate of discovery of new EBPs. Exam-
ples of large-scale implementations of EBPs in mental health are described with emphasis
on the factors thought critical for success. The need for designing systems which can cost-
effectively implement new EBPs is highlighted. Finally, the implications for psychiatric
administrators are discussed.
Well into the second decade of evidence-based medicine, it has become clear that ﬁnding
effective treatments for psychiatric disorders and disseminating information about them to
clinicians does not guarantee that they will be implemented . In fact, individual clinician,
practice, clinic, hospital, organizational or agency decisions to implement evidence-based
practices (EBPs) or guidelines do not guarantee improved clinical outcomes . Professional
organizations , government agencies [4–7], accrediting organizations , and consumer
advocacy groups  have recognized the need for mechanisms to speed dissemination of
therapeutic advances and to facilitate implementation. Considering clinical trials cataloged
by Medline (OVID) there has been a 400% increase in the rate of published clinical trials on
R. M. Bloch, Ph.D. (
) · S. A. Saeed, M.D.
Department of Psychiatric Medicine, Brody School of Medicine at East Carolina
University Greenville, NC 27834
J. C. Rivard, Ph.D.
Senior Research Analyst, National Assn. of State Mental Health Program Directors
Research Institute (NRI), NC
C. Rausch, M.S.W.
Private practice consultant,
Saxapahaw, NC 27340