Building the Evidence-Based Organization

Supporting System-Wide Clinical Practice Change

Pinpoint organization-specific opportunities to accelerate the adoption of evidence-based practices and learn how to build a “culture of adherence” across the medical staff.

Executive Summary

Though most health system leaders report that their medical staff accepts the importance of evidence-based practice in concept, they still struggle with significant variation in clinical practice, costs, and outcomes. 

So what are organizations with less variation doing differently? They don’t just define a standard of care, they also build an organization-wide “culture of adherence.” This study outlines nine strategies to help clinical leaders do the same at their organizations.

Adopting evidence-based practice advances care quality and efficiency

Health care organizations need to improve cost efficiency and boost care quality—clinical leaders are poised to inflect both by making sure patients receive the right care at the right time. Most organizations are already investing significant time and resources into evidence-based clinical guidelines, but are not seeing consistent adoption. Of course, guidelines do not exist for every scenario. But organizations find that clinicians are not consistently adopting practices that are known to produce better outcomes.

What differentiates top performers

The organizations that have achieved an evidencebased culture—and with a scalable approach—do three things differently.

  • These organizations invest in high-impact resources, including physician leaders and data systems, largely performance-tracking systems and clinical decision-making support.
  • They use a multifaceted approach to support EBP adherence. Instead of focusing on outliers, they surround physicians with support structures that promote EBP uptake.
  • They capitalize on their system advantage. Top-performing organizations maximize the return of their EBP initiatives by ensuring best practices pervade all services and sites.

Overcome the adherence challenge

Building a culture of adherence among medical staff starts with surrounding physicians with effective messaging, data, and other support systems to promote EBP uptake.

For instance, most organizations allow physicians to submit suggested guideline revisions, but few have a dedicated process for filtering and acting on those suggestions. Without a transparent updating process, physicians may lose trust in, and not utilize, guidelines.

At HealthEast Care System, a physician-led informatics group vets all change requests, and uses set criteria to decide on the necessity and priority of each suggested revision. After making (or not making) each change, the group updates the physician on the action taken. This approach strikes the right balance between incorporating new evidence and physician feedback while maintaining the integrity of the care standards.

Capitalize on system advantage

Scaling EBP means leading and supporting clinical standardization efficiently across all services and sites.

Banner Health, for example, strikes the right balance between centralized prioritization and specialty-led execution. They established two separate but complementary efforts. One group uncovers, quantifies, and prioritizes opportunities to improve variation. The other system-level groups, organized by clinical area, develop the standards of care in the areas identified by the first group.

9 lessons to support system-wide clinical practice change

These are just a few examples of how organizations have overcome common pitfalls to widespread EBP adoption. Read the full study for nine lessons to build an evidence-based organization.

Members can read the full study to learn how to:

  • Identify underleveraged EBP support tactics
  • Enfranchise physicians in EBP strategies and adoption by surrounding them with effective data and support
  • Ensure maximum return on EBP efforts by scaling clinical best practices across the organization

Download the study

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