COMBINING EVIDENCE-BASED MEDICINE AND QUALITY IMPROVEMENT:
A PRACTICAL MODEL
We developed a practical model that combines EBM with quality
improvement. EBM provides tools to identify interventions to improve patient outcomes.
However, it typically is concerned only with applying that knowledge to the patient
before the physician or nurse. Quality improvement provides a means to translate
these effective interventions into performance measures, monitor their use, and redesign
the system to ensure patients receive them. Our model is outlined below:
- Pick an important clinical area—an area that has an impact on the
lives of patients and has evidence for what we should be doing and for which there
is a gap between what we should do and what we currently do.
- Identify interventions that improve outcomes for this area. For this,
we need to define important outcomes and use traditional EBM.
- Measure whether we are doing what we should. Here, we translate the interventions
to measures of performance. Caution is needed to balance validity and feasibility.
- Redesign work to ensure patients receive those interventions.
- Evaluate whether patient outcomes improved as a result of the changes.
