Introduction to Evidence Based Practice

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Introduction toEvidence Based Practice

• Tony Roberts
• Clinical Effectiveness Specialist Advisor
• South Tees Hospitals NHS Trust,
• Tees PCTs and
• Honorary Research Fellow, Durham University
• John Blenkinsopp
• Clinical Effectiveness Advisor
• North Tees and Hartlepool NHS Trust
• Amanda McGough
• North Yorkshire and York PCT
• Emma Carter
• Clinical Audit Manager
• South Tees Hospitals NHS Trust
• www.evidencebasedpractice.org.uk

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EBP is part of Clinical Effectiveness

• Clinical Effectiveness is doing the right thing
  and the thing right
• Evidence based Practice Basically, using the
  published systematic research base to specify how
  specific groups of patients should be managed
  (which diagnostic procedures and treatments
  should be used) and to predict outcomes achieved
  in terms of patient mortality, morbidity and
  quality of life
• Implementing change to ensure services deliver
  up-to-date treatments in an efficient manner with
  the resources to support them (PbR etc)
• Routine monitoring of data (activity and
  outcome), clinical audit, risk management
  (incidents, complaints), infection control and
  patient experience to determine whether patients
  receive the benefits predicted by the
  evidence-base and to ensure efficient deployment
  of resources

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Why do we need EBP?

• Patients - the best individualised care
• Staying up-to-date
• Knowing when to implement change in routine
  practice
• Working together to develop services
• Planning for change

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Integrating the evidence
The patients values and preferences
The best clinical decision
The clinicians expertise
The best available evidence from systematic
research
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Evidence-Based PracticeImplementing research
findings in practice
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Evidence Based Practice

• Evidence-based Medicine practice is the
  conscientious, explicit and judicious use of
  current best evidence in making decisions about
  the care of individual patients. The practice of
  evidence-based health care means integrating
  individual clinical expertise with the best
  available external clinical evidence from
  systematic research
• Sackett DL, Rosenberg WMC, Gray JAM, Haynes RB,
  Richardson WS. Evidence based medicine what it
  is and what it isnt. BMJ 199631271-2.

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Clinical Governance

• A framework through which NHS organisations are
  accountable for continuously improving the
  quality of their services and safeguarding high
  standards of care by creating an environment in
  which excellence in clinical care will flourish.

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Clinical Governance
The new NHS says A quality organisation will
ensure that evidence based practice is in
day-to-day use with the infrastructure to support
it
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Infrastructure for EBP

• Information access
• NHS Library, NICE, Medline, CINAHL, Clinical
  Evidence, Cochrane Library, Specialist Libraries
• Internet
• EBP (esp. Critical Appraisal) skills training, EB
  Journal Clubs, multi-disciplinary opportunities
  for these
• Methods for disseminating summaries of evidence,
  NICE guidelines, pathways, care bundles etc
• Methods for monitoring the process and outcomes
  of care

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Using robust, clinically led, measurement to
improve care
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Getting the predicted improvement in outcome
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SummaryEBP for life long learning

• We cant teach you the whole of EBP in two and a
  half days, but we hope to inspire you to want to
  learn more and to point you in the right
  direction
• It is important to put personal study time into
  following up what you learn on this course, each
  session assumes youve not really prepared!
• The benefits for patients are clear, but it also
  makes your working life more satisfying and
  enjoyable
• The best way to learn is to have fun, so relax
  and enjoy the course. Thanks for making the
  effort to come.