Barriers and facilitators to evidence-use in program management: a systematic review of the literature

BACKGROUND The use of evidence in decision-making at the program management level is a priority in health care organizations. The objective of this study was to identify potential barriers and facilitators experienced by managers to the use of evidence in program management within health care organizations. METHODS The authors conducted a comprehensive search for published, peer-reviewed and grey literature that explores the use of evidence in program management. Two reviewers selected relevant studies from which data was extracted using a standard data abstraction form and tabulated for qualitative analysis. The results were summarized through narrative review. The quality of the included studies was assessed using published criteria for the critical appraisal of qualitative, quantitative and mixed methods research. RESULTS Fourteen papers were included in the review. Barriers and facilitators were categorized into five main thematic areas: (1) Information, (2) Organization--Structure and Process, (3) Organization--Culture, (4) Individual, and (5) Interaction. CONCLUSION This paper reviews the literature on barriers and facilitators to evidence-informed decision-making experienced by program management decision-makers within health care organizations. The multidimensional solutions required to promote evidence-informed program management can be developed through an understanding of the existing barriers and facilitators of evidence-use.