Evidence-Based HealthCare (EBHC) and Best Practices. Communication. Collaboration. Learning.

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Susanna Bates
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1 Evidence-Based HealthCare (EBHC) and Best Practices Communication. Collaboration. Learning.

2 Conflict of Interest Jerry Stonemetz, MD Vice Chairman; Anesthesia & Critical Care Medicine Johns Hopkins University Founder and Chief Medical Information Officer for ShareSafe; have minority stake ownership Will be discussing use of ShareSafe Social Media product

Evidence-Based Medicine Patient Values Current Best Evidence Clinical Expertise Systematic approach: Lifelong self-directed learning Caring for patients triggers need for important research-based

3 Evidence-Based Medicine Patient Values Current Best Evidence Clinical Expertise Systematic approach: Lifelong self-directed learning Caring for patients triggers need for important research-based information about: Clinical issues Other healthcare issues Decision Dawes M, et al. Sicily statement on evidence-based practice. BMC Med Educ 5: 1 (2005) doi: / Sackett D. Clinical epidemiology: what, who, and whither. J Clin Epidemiol 55: (2002) doi: /s (02)00521

4 Translating Research Into Practice Research 15 Years Practice Agency for Healthcare Research and Quality

5 Conceptual Model of Evidence-based Decision Making in GPs EBH steps Evidence Clinical problem Experience, expertise Physician s preferences Decision Education Patient s preferences Sandra Zwolsman et al. Br J Gen Pract (2012);62:e511-e521. Adapted from: Sackett DL, Rosenberg WM, Gray JA, et al. Evidence based medicine: what it is and what it isn t. BMJ 312(7023):71 72 (1996). Offringa M, Assendelft WJJ, Scholten RJPM. Introduction to evidence-based medicine. Clinical treatment based on evidence. 3rd edn. Houten: Bohn Stafleu van Loghum (2010)

6 EBHC Competencies Young T et al. What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews. PLoS ONE 9(1): e doi: /journal.pone (2014)

Disseminating Evidence-Based Practices Strategy 1 Strategy 2 Strategy 3 Strategy 4 Strategy 5 Strategy 6 Strategy 7 Strategy 8 Highlight evidence base and relative simplicity of recommended practices.

7 Disseminating Evidence-Based Practices Strategy 1 Strategy 2 Strategy 3 Strategy 4 Strategy 5 Strategy 6 Strategy 7 Strategy 8 Highlight evidence base and relative simplicity of recommended practices. Align the campaign with the strategic goals of the adopting organizations. Increase recruitment by integrating opinion leaders into the enrollment process and employing a nodal organizational structure. Form a coalition of credible campaign sponsors. Generate a threshold of participating organizations that maximizes network exchanges. Develop practical implementation tools and guides for key stakeholder groups. Create networks to foster learning opportunities. Incorporate monitoring and evaluation of milestones and goals. Bradley EH et al. Blueprint of effective strategies in the dissemination of evidence-based practices through a National Quality Campaign strategy. The Commonwealth Fund 1399, Vol 86 (2010)

Best Practice in Healthcare Practice not yet backed by rigorous research May be local hospital determines a particular practice has resulted in improved outcomes for its patient population An

8 Best Practice in Healthcare Practice not yet backed by rigorous research May be local hospital determines a particular practice has resulted in improved outcomes for its patient population An imprecise and moving target Rapidly changing knowledge Disagreement over the efficacy of recommended practices Difficulty adjusting to new clinical, organizational and interpersonal routines The need to modify practices to be context appropriate

9 Barriers to Implementation of EBHC and Best Practices Communication Collaboration Learning Metrics

10 Social Media in Healthcare Patient engagement Education; obtaining information; disease networks Healthcare Communities Fundraising; Customer Support; advertising new services Physicians Online communities for discussing patient care issues; new research; updated clinical practices Househ M. Social media in healthcare. Stud Health Technol Inform; 183: (2013).

11 Mayo Clinic Considered to have greatest use of Social Media Created Mayo Clinic Center for Social Media Has support from executive leadership Currently less than 26% of all hospitals use Social Media Pennic J. 5 reasons why Mayo Clinic dominates social media in healthcare

12 McKinsey Global Institute Twice as much potential value lies in using social tools to enhance communications, knowledge sharing, and collaboration within and across enterprises. Estimates suggest that by fully implementing social technologies, companies have an opportunity to raise the productivity of interaction workers high-skill knowledge workers, including managers and professionals by 20 to 25 percent. Chui M et al. The social economy: Unlocking value and productivity through social technologies. McKinsey Global Institute

13 HCA Medical Director, Anesthesia Services 172 hospitals; 122 surgical centers > 2000 anesthesiologists/crnas No method of common communication Quandary dissemination of Best Practices

14 Solution: ShareSafe

15 Johns Hopkins ACCM: Two Communities

16 Hospital Enterprise Private Discussion Groups HIPAA-secure communication Creating the vision Instantaneous Learning ShareSafe has changed the way we communicate. It has increased my productivity by 30 40%. Paul Read, RN, MSN CNO, Springhill Medical Center (Mobile, AL)

17 Documentation Compliance: Best Practices

18 Concurrent Analytics : Compliance Engagement Learning Status

The professional development of physicians is a lifelong. Continuing Medical Education: A New Vision of the Professional Development of Physicians

A R T I C L E Continuing Medical Education: A New Vision of the Professional Development of Physicians Nancy L. Bennett, PhD, Dave A. Davis, MD, William E. Easterling, Jr., MD, Paul Friedmann, MD, Joseph