Research continues to expand our understanding of clinical best practice, but translating those theoretical insights into everyday care remains one of the aged care sector’s most persistent operational hurdles.
For facility leaders managing fast-paced environments, distributing a new manual and hoping for compliance is no longer a workable strategy.
New research from Monash University reveals that strategic, systems-level approaches are vital to closing this gap. By turning research into action – instead of just handing out manuals – providers can improve daily care and raise the quality of life for residents.
The EMBRACE trial
Led by researchers at the Centre for Medicine Use and Safety (CMUS) – part of the Monash Institute of Pharmaceutical Sciences (MIPS) – a major multi-state trial called EMBRACE evaluated how structured implementation strategies change staff behaviour. Rather than relying on static documentation, the project partnered with four aged care providers across 19 residential facilities in New South Wales, Queensland, Western Australia, and Victoria.
The goal was to operationalise Australia’s Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Care. To support staff, the research team developed targeted resources, including nine fact sheets, a practical 10-item checklist to monitor medication side effects, and a custom companion guide for people living with dementia and their families.
Traditional models of sharing guidelines consistently fail because they ignore the operational realities of residential care. Professor Simon Bell, Director of CMUS, noted that the pressure cooker environment of aged care demands more than passive reading material.
“Improving medication safety in residential aged care requires new strategies to bridge the gap between research evidence and clinical practice,” Professor Bell said.
The evolving role of knowledge brokers
A companion study published in BMJ Quality & Safety examined how intermediaries – known as knowledge brokers – can bridge the evidence-to-practice divide. These brokers worked at a systems level to help facilities build, deliver, and evaluate local quality improvement projects from the ground up.
According to Professor Bell, establishing these roles required a careful, context-driven foundation.
“Over the course of the 12-month trial, we watched these roles evolve from the ground up. The knowledge brokers began by understanding the local context and building relationships with staff,” Professor Bell said.
However, placing a knowledge broker into a facility doesn’t guarantee success in a vacuum. CMUS Senior Research Fellow Dr Amanda Cross emphasised that sustainable quality improvement demands a clear grasp of organisational structure and service design.
“Our companion study found that a knowledge broker’s success was heavily shaped by facility leadership, organisational culture and dedicated implementation support, she explains.
“Together, the studies demonstrate that developing a high-quality guideline is only one part of improving evidence-based care, but how guidelines are implemented is equally important.”
“New guidelines being developed in accordance with Australia’s National Health and Medical Research Council standards involve an integrated knowledge translation approach, where the acceptability and feasibility of recommendations are considered at the outset,” Dr Cross explained.
A map for navigating evolving reform
The implications of these findings stretch far beyond psychotropic medication management.
As Australia’s aged care sector continues its broader transformation – introducing complex new care models and embedding integrated workforce roles, like onsite pharmacists – leaders must look closely at implementation science.
For teams navigating reform, this research offers an essential operational map. It shows that translating clinical evidence into everyday practice needs intentional, systems-level leadership, supportive workplace cultures, and an acute understanding of how care is delivered on the ground.
