The Chain of Codified Knowledge: Organisational Enactment of Evidence-Based Health Care in Four High-Income Countries

Kislov and colleagues draw on multiple qualitative case studies of evidence-based nursing conducted in Sweden, Canada, Australia and the UK to describe the chain of codified knowledge which reflects the institutionalisation of evidence-based practice as organisational “business as usual”. This chain is dominated by performance standards, policies and procedures and locally collected data, i.e. various forms of “evidence by proxy” which are, at best, informed by research only partly or indirectly, but are nevertheless perceived as credible evidence. This chapter reveals dual effects of this codification dynamic on evidence-based practice and highlights the influence of macro-level ideological, historical and technological factors on the composition and circulation of codified knowledge. It concludes by outlining the practical implications of the study for change agency in health-care reform.