Clinicians

For decades it has been clear that when patients receive evidence-based care, their outcomes improve by 28-35% (Heater 1998).

In 2003, the Institute of Medicine called for 90% of healthcare decisions to be evidence-based by 2020 in order meet the goals set to achieve improved patient experiences and outcomes.

In 2009, Riley published 6 recommendations for achieving high reliability in healthcare organizations, which included a “culture of evidence-based practice”.

In 2010, Sammer et al., described the 7essential components of a culture of safety where EBP was one of the components.

In a study by Melnyk et al., (2012), clinicians identified current barriers to EBP; time to do EBP, EBP education and resources, availability of EBP mentors, organizational culture rooted in tradition, and resistance from clinical peers, colleagues, managers, and leaders. Clinicians expressed their need for support (as opposed to resistance) from the organization, managers, and interdisciplinary colleagues in order to be able to implement EBP.

Over the past decade, Melnyk, Fineout-Overholt and colleagues have repeatedly found that clinicians’ beliefs in EBP are strongly correlated to whether they implement EBP or not. The findings reflect that clinicians who believe that EBP is important to patient outcomes AND who believe EBP is possible (supported) in their practice settings are more likely to implement EBP.

The case for EBP is clear. It is the right thing to do.

Best care is patient centered and evidence-based.

High priority healthcare outcomes are achieved through integration of evidence-based practices.

Professional clinicians are ethically obligated to provide the best care possible.

Clinicians implement EBP when they believe it is important and that it is possible in their organization.

Most professional clinicians were never taught the EBP process, so they need to learn it!

Why aren’t’ most clinicians learning about EBP?

Why aren’t most clinicians integrating evidence into their practices?

What is preventing clinicians form becoming evidence-based?

CLASSIC AND CURRENT BARRIERS TO EBP:

  • TIME
  • LACK OF RESOURCES
  • LACK OF KNOWLDEGE
  • LACK OF MENTORS
  • LACK OF SUPPORT FROM COLLEAGUES, PEERS
  • LACK OF SUPPORT FORM MANAGERS AND LEADERS
  • LACK OF ORGNIZATIONAL CULTURE THAT SUPPORTS EBP

CLASSIC AND RECENT COMMENTS ABOUT EBP FROM CLINICIANS:

  • “It’s hard”
  • “I don’t have time”
  • “I don’t know how to do it”
  • “There’s no one in our organization with that kind of expertise”
  • “There’s a lot of pressure to do things…the way we’ve always done it around here!”
  • “My manager can never release me to go the EBP council meetings, we’re always too busy on the unit”
  • “This organization doesn’t support EBP….or change of any kind for that matter!”
  • "The leaders talk about EBP, but they don’t really support EBP efforts. I don’t think they even know what EBP is!”
  • “The physicians are very resistant to EBP, they like things just the way they are….and have always been” 

Here is the misperception:

EBP is something that clinicians need to do…

“ON TOP OF EVERYTHING ELSE”.

Here is the truth:

EBP is something that clinicians need to do…

“AS THE FOUNDATION OF EVERYTHING ELSE.”

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Despite the urgency to implement and sustain this new practice paradigm, the integration of evidence into practice continues to be perceived as a challenging and burdensome.

Much of the distress stems from a lack of EBP knowledge, skills and/or attitudes across the system, from executive suites to the bedside.

Approaching the complex challenge to deliver best, evidence-based healthcare practices to achieve excellent outcomes will require innovative thinking and courageous acts.

The time is now.

Fuld Institute for EBP can help!

We have evidence-based, powerful solutions that can be customized for your organization!

We can teach you how to do EBP.

We can teach you how to sustain EBP.

We can design infrastructures to support EBP.

We can show you the impact of EBP on high priority outcomes.

We can make EBP a reality in your organization.