Cincinnati Children’s believes in and practices evidence-based decision making (EBDM) as a way to achieve the best, safest care for children. Patients, purchasers, regulators and others expect practice to be based on sound judgment and best evidence; however, the proportion of clinical practice that has a basis in published scientific research is lower than one would expect. And the time it takes to translate new research findings into clinical practice can take years.
With this in mind, Cincinnati Children’s designed a division within the James M. Anderson Center for Health Systems Excellence to promote, support and spread EBDM to the point of care. The value of EBDM was recognized when the Board of Trustees incorporated evidence initiatives into the medical center’s strategic plan, making it our mission to be the leader in evidenced-based care locally, regionally and around the world. This work is led by Wendy Gerhardt, MSN, RN-BC, and William Brinkman, MD, MEd.
How We Promote Evidence
Our evidence group has focused on several key processes and resources to support EBDM throughout the medical center:
Horizon scanning, evidence synthesis (e.g., rapid evidence reviews), embedding evidence and measuring and spreading evidence adoption are used to close the gap between evidence generation or publication and use of the evidence in decision making at the point of care.
Evidence-based tools are used to facilitate clinicians' communication about treatment options and patients / parents' communication about the personal value they place on the trade-offs involved. The goal is to reach agreement on the best strategy for a patient when there are two or more medically reasonable options differing in ways that are important to families.
We collaborated with groups from nursing (patient services), allied health (occupational therapy / physical therapy), hospital medicine and our medical research library to develop the LEGEND (Let Evidence Guide Every New Decision) system, standardizing EBDM education and evidence evaluation for the institution. This system includes tools and resources for proceeding through the evidence evaluation process, including critically appraising individual studies, grading the body of evidence and judging the strength of recommendation statements.
- Best evidence statements: We use best evidence statements to improve recommendation development and streamlined evidence reviews to improve revision processes.
- Evidence-based care guidelines: We develop and disseminate high-quality processes and products, primarily evidence-based guidelines.
