Improving Quality with Evidence: Equipping interprofessional clinical teams to integrate research evidence into practice

Background

Ideally, patient care decisions are always based on the best available scientific evidence; in reality, however, this is not the case. Moreover, scientific evidence often takes 15 to 20 years to be incorporated into routine patient care. There are many barriers for clinicians in applying principles of EBP into everyday practice that lead to wide variations in care.

Methods

The Medical University of South Carolina’s (MUSC) Center for Evidence-Based Practice (EBP) developed an evidence-based practice, project-based workshop, geared at interprofessional teams of clinicians within the MUSC Children’s Hospital. The workshop equips clinicians with the skills necessary to make evidence-based decisions during every day clinical practice, and improve and standardize care on a systematic level. During the course, participants frame clinical questions, search the most recent literature, evaluate evidence, and develop practice recommendations that drive care for a particular clinical topic. These recommendations are then integrated into MUSC’s EMR.

Results:

The primary outcome assessment is the development of a clinical pathway and accompanying order set by each participating clinical team. Ten teams with over 50 clinicians participated in the course that ended in May 2014, resulting in the development of 10 clinical pathways. Individual participants also received a pre- and post- evaluation to assess the change in their knowledge and skills related to EBP, and their utilization of EBP resources. In addition, each interprofessional team selected a number of quality metrics relevant to their clinical topic to monitor the clinical and financial effectiveness of the order set.

Conclusions:

The EBP clinical decision support tools developed as a part of the course are embedded within MUSC’s EMR, specifically through computerized physician order entry. This integration both facilitates and standardizes evidence-based decision-making.

The interprofessional aspect of the Children’s Hospital course ensures the delivery of comprehensive, coordinated, evidence-based care across the clinical spectrum.