Knowing how to treat the patient in front of you is not really a problem for healthcare professionals today in the vast information society we all are a part of. The problem is knowing exactly which investigation, treatment or medication is right for the patient in front of me out of the hundred different options a simple Google search will tell me. So how do we guide our staff to choose the right medication or treatment? Is curling the way forward?
Evidence-based practice (EBP) was instigated by Archie Cochrane’s questioning of the validity behind doctors’ different medical decisions. Cochrane meant that if systematic tests were carried out on how different treatments may change the results, so called randomised controlled trials, ineffective treatments and investigations could be eliminated.
The most common definition of EBP is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. But how do we get knowledge into practice?
The translation of knowledge to practice might need a little help on the way. To use facilitators in healthcare as a way of aiding healthcare professionals to make the right decisions is a strategy that have been used in Sweden for quite some time. However, as Sweden is building a new national system for knowledge management, in what seems to be supersonic speed, it urges us as policy makers, managers and researchers to really look into our facilitators’ knowledge of how to, exactly, implement knowledge. What knowledge do our facilitators have to implement EBP and how do we support them? The new Swedish system for knowledge translation will through structured national expert groups provide Swedish healthcare with a consensus of evidence covering the most of public healthcare today, which will challenge everyone in healthcare to evaluate and in some cases lead to change of practice. However, how fast can we change practice, with or without facilitators?
Research shows that with knowledge of implementation approximately 80 percent of planned change will occur after three years. Without knowledge of implementation 14 percent of the planned change will occur – after approximately 17 years. That says it all – curling is needed if we want to be able to provide our population with an evidence-based healthcare.
So, to facilitate or not – is not really the question. The question is this: How do we facilitate implementation of new evidence in the most evidence-based way?
Helena de la Cour – EHMA YAC, April 2018