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Introduction

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The Social Organization of Best Practice

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Abstract

This chapter introduces the study and establishes its historical context and key terms. This book represents a now historical ethnographic account of a particular time in which the Ontario Stroke Strategy (OSS) was being implemented in Ontario, Canada, with the explicit aim of ‘improving best practice care across the continuum’. It offers an explication of how the discourses of both evidence-based medicine (EBM) and knowledge translation (KT) were institutionalized in the OSS. At the time, the rising emphasis on knowledge translation was relatively new. It has since become firmly enshrined across all aspects of health research funding, clinical care guidelines and government policy. While the terms used to describe KT have multiplied and evolved, many of its key features arguably remain the same in the more contemporary practices of EBM. I theorize it then and now as a text that is the managerial arm of EBM.

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Notes

  1. 1.

    Towards an Integrated Stroke Strategy for Ontario—Report of the Joint Stroke Strategy Working Group June 2000; the Ontario Best Practice Guidelines for Stroke Care; and the results of the Canadian Stroke Strategy Information & Evaluation Consensus Panel, September 2005 .

  2. 2.

    For an outstanding history of evidence-based medicine, see Timmerman, S., and Berg, M. (2003). The gold standard: The challenge of evidence-based medicine and standardization in health care. Philadelphia: Temple University Press.

  3. 3.

    Over its evolution, the Ontario Stroke Strategy has gone through several name changes, for example, the Ontario Stroke System. For the sake of consistency, I have referred to it as the Ontario Stroke Strategy (OSS) throughout this book.

  4. 4.

    The National Institute of Neurological Disorders and Stroke (NINDS ) Study Group reported that ‘Despite an increased risk of symptomatic intracerebral hemorrhage, treatment with intravenous t-PA within 3 hours of the onset of ischemic stroke improved clinical outcomes at 3 months’ (National Institute of Neurological Disorders and Stroke, 1995, pp. 1581–1587).

  5. 5.

    The Lazarus Effect refers to a situation in which a ‘full and fast restoration of cerebral blood flow in proximity to the initiation of intravenous tissue plasminogen activator (IV tPA) treatment occurs’ (Yarovinsky, Eran, & Telman, 2015, p. 179).

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Authors and Affiliations

  1. Arthur Labatt Family School of Nursing, Western University, London, ON, Canada

    Fiona Webster

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  1. Fiona Webster
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Correspondence to Fiona Webster .

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Webster, F. (2020). Introduction. In: The Social Organization of Best Practice. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-43165-5_1

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  • DOI: https://doi.org/10.1007/978-3-030-43165-5_1

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  • Publisher Name: Palgrave Macmillan, Cham

  • Print ISBN: 978-3-030-43164-8

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