Friday, July 13, 2007
Promoting EBP: different targets, different strategies
Evidence Based Practice (EBP) is a paradigm introduced in the 1990s that is now known to many, but practiced by few in clinical health care. However, EBP is more and more promoted by hospitals, insurance companies and governments to improve quality of, and justify choices in, health care.
To describe how EBP can be introduced and sustained in a clinical setting.
In 1992, our hospital board of directors decided to define EBP as a spearhead activity. This has launched a local evidence-based guideline development programme, EBP teaching programmes, clinical research activities and, recently, an EBP support centre. In order to reach a sufficient level of knowledge as well as actual use of EBP, basic knowledge and application of EBP principles have been taught with a transdisciplinary approach to doctors, nurses, and management, both at the undergraduate and postgraduate levels.
Knowledge and application of EBP has gradually increased among doctors, managers and nurses. Training of members of the medical staff has created a welcoming environment for EBP activities, for example during daily briefings and regular (scientific) meetings. EBP has been incorporated as an integral part of medical and nursing curricula. At present, the majority of the medical disciplines are aware of and using EBP in daily clinical practice. Nurses are lagging behind, but are encouraged to apply basic EBP skills. The management is convinced about the importance to apply EBP and fosters a constructive critical attitude towards common activities concerning why these are performed.
The ‘conversion’ towards EBP can be achieved trough continuing and transdisciplinary efforts to train all health care professionals involved. Not everyone needs to attain the same level of knowledge or practice. However, the hospital management and staff should be willing to financially support and to create a stimulating environment to let EBP flourish.