Hawaii's statewide evidence-based practice program.

Hawaii's innovative statewide evidence-based practice program facilitates practice change across multiple health care systems. The innovation eliminated duplicative efforts and provided resources, was compatible with the values of health care organizations, and had experience with a pilot program. Interpersonal and mass media communication promoted and embedded the practice change. Users included nurse champions with multidisciplinary team members. The rate of adoption varied across projects and, although resources seemed to be a major determinant of successful institutionalization, there does not seem to be a predictable pattern of successful project implementation.