Stack and Hlela, and Khosa found that the challenges included hurried policy implementation; limited consultation with the implementing actors; lack of prioritisation, insufficient time, and a lack of co-ordination between different government departments (12, 14).
Many of the challenges and constraints were addressed in the course of project implementation through consultations facilitated by the external consultant to establish solutions as they are identified.
For example, question prompt lists have been used quite widely, but their actual implementation in consultations is not always straightforward and their rates of success do vary.
Some expressed expectations involve support for implementation from external consultants (consultation, supervision, or team analysis), for instance, "supervision regarding conflict management within the team", "consultation and supervision regarding stressful experiences in patient care" or the desired "analysis of team processes".
In 2005, a further phase of health R&D reform was proposed in the Best Research for Best Health consultative report [ 21] and, following consultation, implementation of its recommendations began in 2006 with the creation of the National Institute for Health Research NIHRR), led by the Director of R&D in the Department of Health [ 9].
The implementation of nursing consultation in the nursing home wards is time-consuming.
The systems consultation implementation strategy is intended to generalize to the adoption of other clinical guidelines.
The most oft-cited barrier to widespread implementation of electronic consultation or integrated eCR systems was a lack of resources.
This research will pilot test an innovative implementation strategy – systems consultation –intended to speed the adoption of evidence-based practice in primary care.
The study shows that implementation of a consultation model offering the elements of more time for the patient and provision of the expertise of case specific members of a primary care team did not have any effect on anxiety and depression in mothers from a socio-economically deprived area.
