Article type
Year
Abstract
Purpose: Most existing centers for health technology assessment (HTA) are associated with payers or government agencies. They most frequently review and analyze emerging and costly technologies. But hospitals often have to make decisions about processes of care that impact not only cost, but also on quality and safety of patient care.
Methods: Our academic medical center created a Center for Evidence-based Practice (CEP) in 2006 for the purpose of gathering scientific evidence and applying it to decision making about purchasing, formularies, and clinical practice. CEP is staffed by two hospitalist co-directors trained in epidemiology, three HTA analysts, physician and nurse liaisons, a librarian, a health economist, and an administrator, totaling 5.5 full time equivalents.
Results: Over 150 evidence reports have been completed to date, 44 in the most recent 12 months. Internal clients requesting reports include clinical departments, quality administrators and hospital committees. Topics have included processes of care like the use of heparin versus saline for catheter flushing; and high-cost and emerging technologies like telemedicine in critical care. Reports review existing guidelines and systematic reviews first, and review primary studies when previously published reviews do not offer sufficient evidence. Local utilization and cost data are incorporated so reports can be tailored to our medical centerás needs. CEP then works to implement findings, including integrating them into computerized clinical decision support, and measures their impact using administrative and clinical data. Evidence reviews are shared publicly through the National Guideline Clearinghouse, the HTA database, and peer-reviewed publications. CEP also offers education through workshops, a resident elective, and courses for medical and graduate students. In addition, CEP has developed collaborations with payors, government organizations, and private industry.
Conclusion: An evidence-based practice center within an academic medical center can educate clinicians and support a culture of evidence-based decision-making.
Methods: Our academic medical center created a Center for Evidence-based Practice (CEP) in 2006 for the purpose of gathering scientific evidence and applying it to decision making about purchasing, formularies, and clinical practice. CEP is staffed by two hospitalist co-directors trained in epidemiology, three HTA analysts, physician and nurse liaisons, a librarian, a health economist, and an administrator, totaling 5.5 full time equivalents.
Results: Over 150 evidence reports have been completed to date, 44 in the most recent 12 months. Internal clients requesting reports include clinical departments, quality administrators and hospital committees. Topics have included processes of care like the use of heparin versus saline for catheter flushing; and high-cost and emerging technologies like telemedicine in critical care. Reports review existing guidelines and systematic reviews first, and review primary studies when previously published reviews do not offer sufficient evidence. Local utilization and cost data are incorporated so reports can be tailored to our medical centerás needs. CEP then works to implement findings, including integrating them into computerized clinical decision support, and measures their impact using administrative and clinical data. Evidence reviews are shared publicly through the National Guideline Clearinghouse, the HTA database, and peer-reviewed publications. CEP also offers education through workshops, a resident elective, and courses for medical and graduate students. In addition, CEP has developed collaborations with payors, government organizations, and private industry.
Conclusion: An evidence-based practice center within an academic medical center can educate clinicians and support a culture of evidence-based decision-making.