Registed Nurses' Association of Ontario

Toolkit: Implementation of Best Practice Guidelines, Second Edition

Leading Change Toolkit™   (3rd edition) 

A third edition of the toolkit, called the Leading Change Toolkit, was released in October 2021 and is an online evidence-based resource available to anyone engaged in a change initiative for lasting improvement. It was developed by RNAO in collaboration with Healthcare Excellence Canada. We recommend using the third edition as it includes updated evidence on the Knowledge-to-Action (KTA) Framework (Graham et al., 2006) and the inclusion of valid and pragmatic tools to support the implementation of the KTA action cycle phases.

In addition, the Leading Change Toolkit features a new implementation framework that integrates social movement action for knowledge uptake and sustainability called the Social Movement Action (SMA) Framework (Grinspun et al., 2020). As the SMA and the KTA frameworks are complementary, they can be used together to accelerate success. 

Toolkit: Implementation of Best Practice Guidelines (2nd edition) 



This toolkit was designed to assist health-care settings in maximizing the potential of BPGs,through systematic and well-planned implementation. It was also designed to accompany the nursing best practice guidelines (BPG) developed by the Registered Nurses' Association of Ontario (RNAO) in order to facilitate their implementation.


The likelihood of success in implementing BPGs increases when:

  • A systematic process is used
  • Appropriate stakeholders are identified and engaged
  • An assessment of environmental readiness for BPG implementation is conducted
  • Evidence-based implementation strategies are used that address the issues raised through an assessment
  • An evaluation of the implementation is planned and conducted
  • Consideration of resources is adequately addressed