Learning and development (L&D) teams can act as powerful knowledge brokers, ensuring that evidence-based changes, practices and new ideas are understood and successfully integrated into daily practice. Through structured education, competency frameworks, and learning interventions, L&D teams can support workforce capability, decision-making confidence, and interprofessional collaboration.

As a pharmacist, I will use deprescribing as an example to explore how we can achieve translation to practice. So, before we dive in, let’s briefly review the concept of deprescribing.

What is Deprescribing?

Deprescribing is increasingly recognised as a critical component of safe and effective medication management, particularly in aged care. Defined as "the process of withdrawal of an inappropriate medication, supervised by a healthcare professional to manage polypharmacy and improve outcomes," deprescribing plays a key role in reducing medication-related harm, improving quality of life, and aligning treatment with a patient’s evolving care goals.

A Quality, Safety and Regulatory Imperative

The World Health Organization (WHO) has highlighted polypharmacy as a key action area in its Global Patient Safety Challenge, "Medication Without Harm." Similarly, the Australian Commission on Safety and Quality in Health Care (ACSQHC) has embedded deprescribing-related actions into multiple clinical governance and medication safety standards.

Despite these regulatory imperatives, deprescribing remains underutilised in practice. Many healthcare providers encounter barriers, including clinician hesitation, patient concerns, system-level disincentives, and cultural norms prioritising prescribing over deprescribing.

What is Knowledge Translation?

Knowledge translation is applying research and evidence-based practices to real-world clinical settings. It ensures that new knowledge is effectively implemented and sustained through structured education, collaboration, and evaluation.

Implementation science supports this by identifying barriers and enablers to change, providing frameworks for systematically embedding best practices. In deprescribing, these approaches help translate guidelines into routine care, improving patient safety and outcomes.

Why is Knowledge Translation Needed?

Translating evolving clinical knowledge into everyday practice is crucial for improving care quality and individual outcomes. Rapid adoption of evidence-based interventions, such as deprescribing strategies and person-centred care models, is essential to meet the sector's growing complexity.

Equally important is identifying and phasing out outdated or ineffective practices, such as using medications with limited benefit in older adults. Effective knowledge translation, driven by L&D, ensures that aged care providers can integrate best practices, comply with evolving standards, and deliver safer, more effective care.

Challenges in Translating Knowledge to Action

Providers across all health, aged or disability care sectors face significant challenges integrating rapidly evolving clinical knowledge into practice, organisational policy and processes.

Many studies have explored barriers to deprescribing, which can be classified as clinician, patient, system, and cultural barriers.

Using our example, here are common barriers to translating deprescribing evidence into practice:

Clinician Barriers

Clinicians often lack tools or resources to assist with deprescribing, which makes it unclear how to approach it. Other barriers include:

• Difficulty balancing the benefits and risks due to limited evidence.
• Uncertainty in decision-making.

Patient Barriers

Patient-related barriers include individuals feeling “given up on” when initiating conversations on deprescribing. Other barriers include:

• Concerns about medication withdrawal effects.
• A fear of the return of symptoms.

System Barriers

System barriers to deprescribing often stem from structural and financial constraints within healthcare settings, making prioritising and sustaining deprescribing initiatives difficult. This includes:

• Lack of incentives or remuneration for deprescribing.
• Feasibility challenges due to multiple prescribers and poor communication.

Cultural Barriers

A workplace with an open culture that respects the expertise of each interprofessional team member allows a platform to share concerns. It facilitates a decision-making process for sharing, which will be most successful in implementing a deprescribing initiative. This helps overcome these common barriers:

• Traditional reliance on prescribing over deprescribing.
• Lack of respect for interprofessional expertise.
• Lack of shared decision-making.

Bridging the Gap Between Education and Clinical Practice

While there are clear challenges and barriers to bridging the gap between theory and clinical practice, evidence-based approaches exist to integrate new knowledge into practice effectively.

Structured support and ongoing education can help translate best practices into routine care and avoid slow and inconsistent changes.

Interprofessional Collaboration

This is the deciding factor in how we transcend the barriers to knowledge sharing. In the context of deprescribing, harnessing the expertise of interdisciplinary teams can ensure a well-rounded knowledge translation effort.

• Collaboration among nurses, doctors, and pharmacists enhances deprescribing efforts.
• Ongoing research in aged care settings shows that multidisciplinary teamwork improves medication rationalisation.
• Creating a shared knowledge environment leads to more effective deprescribing initiatives.

Continuing Professional Development (CPD)

CPD enhances knowledge, skills, and confidence, ensuring professionals stay updated with best practices, emerging evidence, and industry standards.

• CPD activities help healthcare professionals stay updated on deprescribing guidelines.
• Resources, such as Ausmed’s courses, provide structured learning opportunities.
• Regular engagement in CPD fosters confidence in initiating deprescribing conversations.

Reflective Practice

Reflective practice is the structured process of critically assessing experiences to improve decision-making, learning, and patient care. It enhances safety and quality by helping professionals identify challenges, clarify accountability, and strengthen teamwork.

Examples include:

• Mentorship and peer discussions facilitate deprescribing decision-making.
• Interdisciplinary team members, such as pharmacists, serve as valuable sounding boards.
• Structured reflection improves problem-solving and clinical reasoning.

Patient-Centred Approach

Keeping the patient at the centre of all discussions is essential. What matters to the patient/resident at every stage of their lives would determine the goals of care. For example:

• Deprescribing should align with the patient’s goals of care.
• Expected benefits and time to benefit should be considered, particularly in life-limiting illnesses.
• Preventative medicines may have limited value in specific patient populations.

Tools, Theories, and Frameworks for Effective Translation

Now, let's talk about the facilitators.

Successfully translating knowledge into practice requires structured approaches that guide implementation and sustain change. Tools, theories, and frameworks provide evidence-based strategies to bridge the gap between learning and action, ensuring deprescribing becomes an integrated part of routine care.

Creating Open Lines of Communication

Open communication is a key enabler of knowledge translation because it:

• Encourages deprescribing discussions in multidisciplinary team meetings.
• Fosters trust between team members to facilitate collaborative decision-making.
• Normalises deprescribing conversations as part of routine patient care.

FRAME Acronym for Deprescribing Conversations

To help initiate conversations about deprescribing, clinicians can use the FRAME acronym. It stands for:

• F = Fortify trust.
• R = Recognise patient willingness or barriers to tapering.
• A = Align tapering recommendations to goals of care.
• M = Manage cognitive dissonance.
• E = Empower patients and caregivers to continue the conversation.

Knowledge-to-Action (KTA) Framework

Tools such as the Knowledge-to-Action (KTA) framework can assist in the transfer of knowledge into practice. The framework comprises two major components: Knowledge Creation and the Action Cycle.

• Knowledge creation - involves developing tools and guidelines that summarise the synthesised knowledge in a user-friendly manner.
• Action cycle—This is where tailored strategies, such as educational workshops, clinical decision-support tools, and interprofessional collaboration, can be developed to facilitate deprescribing.

The Role of Educators and L&D Teams

Educators play a critical role in facilitating this translation of knowledge through a variety of teaching methods, including:

• Scenario-based learning and simulations.
• Support structured competency-building programs.
• Ongoing reflective practice.

Learning and development are continuous processes, with L&D teams playing a crucial role in fostering ongoing growth. While distinct from learning, L&D supports competence and capability, making both elements inseparable yet complementary.

Measuring Impact

Evaluating and demonstrating the impact of L&D initiatives is essential—not only at the individual activity level but also as a core function within an organisation. Measuring effectiveness ensures that training translates into meaningful outcomes, such as improved workforce capability, compliance, and care.

L&D teams can also use impact to showcase their value, drive continuous improvement, and align education strategies with organisational goals.

Specific deprescribing impact can be measured by:

• Patient outcomes, such as falls reduction and improved quality of life.
• Compliance with accreditation standards.
• Performance evaluations related to deprescribing knowledge and practice.
• Ongoing integration of deprescribing education into L&D strategies.

Case Study: Deprescribing in Action

Individual Profile:

• Mr. RB, 89 years old, is experiencing recurrent falls.
• History of well-controlled hypertension, no significant comorbidities.

Intervention:

• The in-charge RN observed low blood pressure trends.
• The issue was raised during a multidisciplinary team meeting.
• A medication review was conducted, leading to a shared decision to reduce antihypertensive dosage.
• Additional occupational modifications were implemented to reduce fall risk.

Outcome:

• Falls prevention strategy was strengthened through deprescribing and environmental modifications.
• Demonstrates the power of structured team discussions in improving patient safety.

In this case study example, deprescribing was successfully initiated because of structured team discussions and an open learning culture. L&D teams can create environments where deprescribing becomes business as usual rather than an ad-hoc decision.

By positioning deprescribing within quality improvement, patient-centred care, and risk reduction strategies, organisations can ensure deprescribing is not just encouraged but expected.

The Role of Learning and Development Teams in Scaling Deprescribing

Deprescribing is a complex, multidisciplinary challenge that requires ongoing education, cultural change, and structured decision support. While individual clinicians can lead deprescribing efforts, L&D teams are critical in ensuring deprescribing is embedded into clinical workflows, professional development, and workforce capability-building.

Key ways L&D can support deprescribing translation into practice:

• Embedding deprescribing principles into induction, annual mandatory and competency training.
• Facilitating interprofessional learning through case-based discussions and scenario-based training.
• Providing structured frameworks and decision-support tools.
• Measuring the impact of deprescribing education through competency assessments and practice change evaluations.

Deprescribing is not simply about stopping medications; it is about optimising care. Using this as an example shows that with strong leadership from L&D teams, deprescribing and many other best practices can move from a theoretical best practice to a core component of safe, high-quality healthcare.

Relevant Education and Training Resources

• Deprescribing Medicines - Dr Jenny Gowan
• Conducting a Medication Review - Ausmed
• Prescribing Cascade - Dr Gauri Godbole

Practical Tools for Deprescribing

• Australian Deprescribing Network – Resources for clinician and patient education.
• STOPPFall Deprescribing Tool – Online deprescribing decision tool.
• G-MEDSS – Clinical decision support for medication reviews.
• Australian Commission on Safety and Quality in Health Care – Best practice guidelines for falls prevention

References

• A systematic review of the emerging definition of 'deprescribing' with network analysis: implications for future research and clinical practice (2015) - British Journal of Clinical Pharmacology
• The third WHO global patient safety challenge: Medication without harm (n.d.) - World Health Organization
• Spotlight issue: Polypharmacy (n.d.) - Australian Commission on Safety and Quality in Health Care
• Deprescribing (2011) - Australian Prescriber
• Communication techniques for opioid analgesic tapering conversations (n.d.) - Australian Deprescribing Network

Disclosure

Gauri Godbole is currently practising as a research pharmacist on the G-MEDSS project.

Author