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Illustration of three different hospital rooms with various activities

Implementation and sustainability of best practice guidelines

A tale of three hospitals

The first issue for 2026 of the peer-reviewed journal, JBI Evidence Implementation,  includes a study examining how best practice guidelines can be implemented in a way that is not only effective in the short term, but sustainable over time.

Focusing on three hospitals in China, the study aimed to identify the key factors that influence whether evidence-based nursing guidelines become embedded in routine clinical practice rather than fading after initial adoption. Using the National Health Service Sustainability Model, the researchers assessed sustainability across three core dimensions: process, staff, and organisational context.

The significance of this work lies in its focus on sustainability, an area that has received far less attention than initial guideline implementation, particularly in China. While best practice guidelines are known to improve patient outcomes, nursing efficiency, and evidence-based practice capability, their long-term impact depends on continued use. 

This study is one of the first in China to systematically evaluate sustainability using a validated international framework, providing an important bridge between global evidence and local practice.

The results showed high overall sustainability scores, indicating a strong likelihood that the implemented best practice guidelines would be maintained. Staff engagement and training emerged as major strengths, however monitoring systems and infrastructure were identified as areas needing improvement.

The study highlights that sustainability depends on three interrelated factors: the clinical value of the guidelines; supportive human and material resources; and alignment with organisational culture and leadership. These findings are relevant for hospitals seeking to scale up and sustain evidence-based practice, and offer guidance on where to invest effort and resources to achieve lasting evidence-based practice change.

The study, Implementation and sustainability of best practice guidelines: a tale of three hospitals, is available in Issue 1 for 2026 of JBI Evidence Implementation.

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