Evidence-Based Practice (EBP)

Source: University of South Australia: https://guides.library.unisa.edu.au/ebp/Apply 

When applying the evidence you are utilising the key elements of evidence-based medicine:

• Best research evidence
• Clinical expertise
• Patient values and circumstance

You need all three components of EBM, not just the evidence.

APPLYING CLINICAL EXPERTISE involves the following:

• Do you have the expertise to implement the recommendations?
• Is the recommended tool/intervention feasible in your setting?
• Will the potential benefits outweigh any potential harm?
• Are there any additional considerations relevant to your organisation? (2)

APPLYING PATIENT PREFERENCES  involves Understanding and respecting patient values and circumstances, and involving them in evidence-based care plans that take into account their circumstances and values. Applying patient preferences requires consideration of the following questions

• What are your patient's circumstances?
• What are your patient's views, values, and beliefs?
• Does your patient have any concerns, stresses, or fears?
• Does your patient have any preferences for treatment? (2)

Applying such patient-centred care  leads to higher patient satisfaction, adherence, and contributes to comprehensive health outcomes beyond clinical indicators. The practice of SHARED DECISION MAKING can facilitate the process of incorporating patient preferences into evidence-based healthcare decisions.

Shared decision making (SDM) is becoming increasingly used in clinical medicine as part of the shift towards patient-centred care. It recognizes the unique circumstances and values of each patient when decision are made about their care. The practice of SDM, when appropriate, enables you to complete the final steps of the EBM cycle (apply the evidence, assess the process) that are so often omitted in EBM training and practice.

According to an Australian expert, shared decision-making (SDM) can be defined as:

“... the process of clinician and patient jointly participating in a health decision after discussing the options, the benefits and harms, and considering the patient’s values, preferences, and circumstances.” (Hoffmann et al. p.1295) (1)

The following video clip explains the basic concepts of SDM from Bond University.

Shared decision making is an important part of delivering person-centred care, which underpins the principles and expectations of the National Safety and Quality Health Service (NSQHS) Standards in Australia. The following guide to SDM is from the Australian Commission on Safety and Quality in Health Care (ACSQHC) . Included are resources on communicating with patients, including risk communication, setting goals of care, resources for clinicians and consumers. and decision support tools.

Shared Decision Making - ACSQHC

The ACSQHC also provides access to SDM videos and webinars