Evidence Based Care

18. 01. 12
posted by: Healthy
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Evidence based care or evidence based medicine is a relatively new concept but the practice has been happening in bits and pieces all through the healthcare industry for a long time now. In order for evidence based care to fully embody its name, it has to embody three aspects. They are patient values and preferences, best evidence, and clinical expertise. The perfect combination of these three practises, signifies the pursuit of the best possible outcomes.

 

Considering that evidence based medicine has begun to gain more popularity and usefulness for healthcare practitioners, the Future of Evidence-Based Medicine will start

with the acceleration of the value-based payment movement that will continue in the years ahead, there is an increasing need for clinicians to have access to the best available evidence to make the best possible decisions to achieve the best possible outcomes. Clinicians must practice evidence-based medicine. This is an exciting time to be in healthcare because of the opportunities for improvement evidence-based medicine provides. Patients will feel confident they are getting the best care possible because treatments are based on the most current medical knowledge. Costs will also decrease when care improves. Concerns, such as avoidable readmissions, can be averted when evidence-based medicine is incorporated into daily healthcare operations. Considering all the possibilities, healthcare organizations are jumping on board and starting the transition to evidence based medicine.

 

Moving entire organizations over to an evidence-based model of care presents a few challenges. First, adopting evidence-based medicine as a new standard of practice requires clinicians to change how they were taught to diagnose and treat patients (i.e., the traditional craftsman approach taught during residency or nursing school). Second, providers are already simply trying to keep up with their workloads to treat patients the best they know how. Introducing a new model of care delivery—and learning how to effectively use it—takes time.

 

They usually take these five Steps to Transition to Evidence-Based Medicine

  1. Ask a clinical question.
  2. Acquire the best evidence possible.
  3. Appraise the evidence (make sure it’s applicable to the population and the question asked).
  4. Apply the evidence.
  5. Assess your performance.

 

  • Ask a clinical question to identify a key problem.

The first step to moving to an evidence-based model of care is to form teams of clinicians whose role is to ask questions to identify the critical few problems that need to be addressed. Examples of major problems most healthcare organizations need to address include improving throughput and reducing readmissions. It’s important to identify a high-priority problem that offers a significant return on investment. Once clinicians see large gains, they become engaged and excited about moving to an improved model of care. Women’s services, ischemic heart care, and surgical departments are examples of areas that typically offer opportunities for major improvements.

 

  • Acquire the best evidence (medical knowledge) possible.

There are many different sources of evidence—from the knowledge clinicians gain from treating their patient populations to new research being discovered from highly organized randomized controlled trials (RCTs). But not all of this knowledge represents high-quality evidence that provides the best insight for patient care.

 

  • Appraise the evidence (make sure it’s applicable to the population and the question asked).

There’s good evidence (e.g., from RCTs) and there’s bad evidence (e.g., from personal experience). Then there’s evidence that falls in the gray area—neither clearly defined as good nor bad. It can be difficult for clinicians to know whether to use evidence in the gray area.

 

  • Apply the evidence to daily clinical practice.

If the evidence passes the appraisal step and adds value to the practice of medicine, then clinicians can incorporate the new knowledge into their daily clinical practice. It’s important to note that evidence-based medicine doesn’t replace a clinician’s expertise or judgment. Its purpose is to enhance their ability to make better care decisions based on the needs and preferences of the patient.

 

  • Assess your performance.

Last, assess any improvements to performance or outcomes the new evidence provides. This can be accomplished by establishing a baseline and then measuring improvements. This is an ongoing process—reassessing and re-measuring any gains or losses should be part of an ongoing cycle to ensure the best outcomes.