What You Need to Know About Evidence-Based Practice
As information systems play an increasingly large role in healthcare, innovative practices are being put in place to harness the full power of that information. Before technology, most clinical practice drew from what providers learned in medical school, the journals they read, and the cases they encountered over the course of their careers — but that information has limitations. Premises become obsolete, methods improve, and some evidence is merely anecdotal. As early as the 1990s, a new system of healthcare administration began taking hold — Evidence Based Practice.
What Is Evidence Based Practice?
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Evidence Based Practice, or EBP, encourages a more scientific approach. It requires practitioners to be critical in evaluating evidence and to compile information about events methodically. EBP formalizes the best clinician practices, policies, and procedures and standardizes them to optimize outcomes and efficiency throughout the patient treatment cycle.
What Is the EBP Process?
The Evidence Based Practice model follows the scientific method. First, a question is posed, such as whether exercise reduces blood sugar. Next, the question is researched, and the best evidence to answer the question is identified. In this example, proof of exercise and blood sugar levels would be relevant, as would dietary intake and medications used by participants. That information is then used to form a hypothesis; for example, that 30 minutes of exercise three times a week will lower blood sugar regardless of diet or medication. The hypothesis is then tested by compiling available evidence. The data is analyzed, and a conclusion is drawn. From that point, the results are applied in clinical practice. Clinicians then form a feedback loop by monitoring the success of treatment.
How Is Evidence Collected?
The evidence in an EBP is often identified as the clinical question is framed. This is typically called PICO. It involves identifying the population (e.g., pre-diabetes patients), selecting a possible intervention (e.g., exercise), comparing what happens when there is no intervention (e.g., no exercise), and identifying the outcome (e.g., reduced blood sugar). The expertise of the clinician and the experiences of providers inform this model, and while that has its limitations, it acts as a starting point for collecting and assembling information to be used as evidence. Often, healthcare providers already have ample sets of objective observations, like blood tests, that are used to draw conclusions.
What Role Does Technology Play?
Modern information systems record and integrate a variety of information which can be linked and correlated just like other forms of evidence. By examining the data from patient histories (as opposed to the anecdotal evidence), it is easy to see what treatments worked, test the progression of treatments, and come to more informed prognoses. The information that technology collects may help practitioners evaluate evidence directly, such as looking at whether a certain exercise regimen is effective, or indirectly, like noticing that patient blood pressure seemed to drop considerably when on an eczema treatment.
Evidence Based Practice is a framework for combining provider experience and knowledge with objective observations to improve healthcare.
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