A system that incorporates evidence based content and clinical decision support includes Quizlet

What is Evidence-Based Practice?

The classic definition of Evidence-Based Practice (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”.2

EBP has developed over time to now integrate the best research evidence, clinical expertise, the patient's individual values and circumstances, and the characteristics of the practice in which the health professional works.3

So, EBP is not only about applying the best research evidence to your decision-making, but also using the experience, skills and training that you have as a health professional and taking into account the patient's situation and values (e.g. social support, financial situation), as well as the practice context (e.g. limited funding) in which you are working.  The process of integrating all of this information is known as clinical reasoning.  When you consider all of these four elements in a way that allows you to make decisions about the care of a patient, you are engaging in EBP.4

Why is Evidence-Based Practice Important?

EBP is important because it aims to provide the most effective care that is available, with the aim of improving patient outcomes.  Patients expect to receive the most effective care based on the best available evidence.  EBP promotes an attitude of inquiry in health professionals and starts us thinking about: Why am I doing this in this way?  Is there evidence that can guide me to do this in a more effective way?  As health professionals, part of providing a professional service is ensuring that our practice is informed by the best available evidence.  EBP also plays a role in ensuring that finite health resources are used wisely and that relevant evidence is considered when decisions are made about funding health services.4

What happened before Evidence-Based Practice?

Before EBP health professionals relied on the advice of more experienced colleagues, often taken at face value, their intuition, and on what they were taught as students.  Experience is subject to flaws of bias and what we learn as students can quickly become outdated.  Relying on older, more knowledgeable colleagues as a sole information source can provide dated, biased and incorrect information.  This is not to say that clinical experience is not important - it is in fact part of the definition of EBP.  However, rather than relying on clinical experience alone for decision making, health professionals need to use clinical experience together with other types of evidence-based information.5

Is not all Published Research of Good Quality?

Not all research is of sufficient quality to inform clinical decision making.  Therefore you need to critically appraise evidence before using it to inform your clinical decision making. The three major aspects of evidence that you need to critically appraise are:

• Validity - can you trust it?
• Impact - are the results clinically important?
• Applicability - can you apply it to your patient?

Clinical decision support systems (CDSS) are computer-based programs that analyze data within EHRs to provide prompts and reminders to assist health care providers in implementing evidence-based clinical guidelines at the point of care. Applied to cardiovascular disease (CVD) prevention, this Domain 3 strategy can be used to facilitate care in various ways—for example, by reminding providers to screen for CVD risk factors, flagging cases of hypertension or hyperlipidemia, providing information on treatment protocols, prompting questions on medication adherence, and providing tailored recommendations for health behavior changes.

CDSS at South Omaha Medical Associates

South Omaha Medical Associates (SOMA) is a family-owned, family-operated clinic that is centrally located in South Omaha, Nebraska. It has a higher percentage of low-income patients than clinics in surrounding areas. SOMA collaborated with the Nebraska Department of Health and Human Services, Douglas County Health Department, and Wide River Health Information Technology to assess its technology needs and make plans to implement CDSS. As a result of this assessment, the clinic increased its use of EHRs and implemented systems to better identify patients with undiagnosed hypertension, increase use and monitoring of clinical quality measures, and increase use of clinically supported self-measured blood pressure monitoring. These changes improved workflow at the clinic and led to a 25% increase in patient visits since the start of the collaboration. In addition, Blue Cross Blue Shield awarded SOMA its Blue Distinction Award for meeting overall quality measures for patient safety and outcomes.

For more information:
Chronic Disease Prevention and Control Program
Nebraska Department of Health and Human Services
301 Centennial Mall South
Lincoln, NE 68509
Email: