Why Is Evidence-Based Practice Important?

1. The Meaning of Evidence-Based Care

In healthcare, providing the best care to patients is the primary goal. Over time, medicine has evolved from relying solely on traditional practices and personal experience to using scientific research and proven methods to guide treatment decisions. This shift is called evidence-based care, and it is considered one of the most important advancements in modern healthcare. Evidence-based care means that healthcare decisions, from diagnosis to treatment, are based on the best available, scientifically proven evidence, rather than solely on past practices or opinions. This approach ensures that patients receive the highest-quality care that is backed by research and data.

key concept

In this lesson, you will explore the meaning and importance of evidence-based care, how it relates to positive patient outcomes, and the models of evidence-based practice. By understanding these concepts, you will see why evidence-based care is critical in today’s healthcare system and how this information can be used by healthcare managers to create an environment of excellence in patient care.

Evidence-based care is the practice of integrating the best available research evidence with clinical expertise and patient preferences to make informed healthcare decisions. In other words, it involves using scientific studies, clinical guidelines, and expert opinions to determine the most effective treatments for patients. It is a process that involves asking the right questions, gathering the most relevant data, critically evaluating that data, and using it to make decisions that are tailored to the patient’s needs.

big idea

The concept of evidence-based care is rooted in the idea that healthcare should be based on facts, not assumptions or outdated practices. Rather than relying solely on what has been done in the past or what a healthcare provider personally believes is best, evidence-based care uses objective, high-quality research to guide medical decisions. This leads to more effective treatments, fewer errors, and better overall care for patients.

term to know

Evidence-Based Care

When healthcare decisions, from diagnosis to treatment, are based on the best available, scientifically proven evidence, rather than solely on past practices or opinions.

2. The Importance of Evidence-Based Care

The importance of evidence-based care lies in its ability to improve patient outcomes, reduce healthcare costs, and ensure that treatments are effective and safe. Here are some of the key reasons why evidence-based care is so important:

2a. Improved Patient Outcomes

When healthcare providers base their decisions on research and evidence, they are more likely to offer treatments that have been proven to be effective. This can lead to better health outcomes for patients, including faster recovery times, fewer complications, and improved quality of life. For example, evidence-based practices in managing chronic conditions like diabetes or hypertension can lead to better long-term control of these diseases, reducing the risk of complications such as heart attacks, strokes, and kidney failure.

2b. Consistency in Care

Evidence-based care helps standardize treatments across healthcare providers, leading to greater consistency in care. When healthcare providers follow the same evidence-based guidelines, patients are more likely to receive the same high-quality care regardless of where they seek treatment. This consistency is particularly important in large healthcare systems or hospitals, where multiple professionals might be involved in a patient's care.

2c. Reduced Risk of Harm

By relying on evidence from scientific studies, evidence-based care minimizes the use of treatments that may be ineffective or harmful. In the past, some treatments were used based on tradition or anecdotal evidence, without sufficient scientific support. By focusing on proven interventions, healthcare providers can avoid unnecessary treatments that might cause harm. For example, certain medications or surgical procedures may have been widely used in the past, but if recent research shows that they are ineffective or risky, they may be replaced with safer, more effective alternatives.

2d. Informed Decision Making

Evidence-based care empowers both patients and healthcare providers to make informed decisions. Patients are given the opportunity to understand the evidence behind different treatment options, and they can collaborate with their healthcare providers to choose the treatment that best suits their preferences and values. For example, if a patient is diagnosed with cancer, evidence-based care ensures that they are informed about the most effective treatment options available, including the risks and benefits of each approach.

2e. Cost-Effectiveness

Evidence-based care can help reduce healthcare costs by ensuring that only effective treatments are used, while unnecessary or ineffective treatments are avoided. This leads to more efficient use of healthcare resources and reduces the financial burden on both patients and the healthcare system. For example, evidence-based practices can prevent unnecessary hospital readmissions or the overuse of expensive medications and tests that may not improve patient outcomes.

3. Positive Patient Outcomes and Evidence-Based Care

One of the most significant benefits of evidence-based care is its impact on positive patient outcomes. When treatments and interventions are based on solid evidence, patients are more likely to experience better results. Here are a few examples of how evidence-based care can lead to positive outcomes.

3a. Improved Recovery Times

Studies have shown that evidence-based practices can lead to faster recovery times for patients.

EXAMPLE

In surgical procedures, evidence-based guidelines for post-operative care, such as pain management and physical therapy, can help patients recover more quickly and reduce the risk of complications.

By following proven practices, patients are more likely to experience fewer setbacks and return to their normal lives sooner.

3b. Better Chronic Disease Management

Chronic diseases, such as diabetes, asthma, and heart disease, are among the most common health issues that patients face. Evidence-based care has been particularly effective in managing these conditions.

EXAMPLE

Guidelines for managing diabetes, such as regular blood sugar monitoring, lifestyle changes, and medication, have been developed based on years of research. Patients who follow these evidence-based practices are better able to control their condition, preventing complications and improving their overall health.

3c. Improved Patient Satisfaction

Evidence-based care helps ensure that patients receive care that aligns with their preferences and values. By considering both the scientific evidence and the patient’s personal preferences, healthcare providers can offer treatments that are more acceptable to the patient. This leads to higher patient satisfaction, as patients are more likely to feel heard and involved in their care.

EXAMPLE

Patients with chronic pain may prefer non-pharmacological interventions, such as physical therapy or acupuncture, which have been shown through research to be effective in pain management.

3d. Lower Risk of Medical Errors

Medical errors, such as incorrect diagnoses or improper treatments, can lead to serious health consequences. Evidence-based care reduces the risk of these errors by providing healthcare providers with clear guidelines and proven methods for diagnosing and treating conditions. By relying on the best available evidence, healthcare providers are less likely to make mistakes, leading to better patient safety and outcomes.

reflect

What are some potential barriers to implementing evidence-based practice in healthcare settings?

4. The Models of Evidence-Based Practice

Evidence-based practice (EBP) is not just about applying research to care—it also involves a systematic approach to evaluating the quality and relevance of evidence. There are various models and frameworks that healthcare professionals use to implement evidence-based practices effectively. There are several models used to guide the process of evidence-based practice. Some of the most widely recognized models include:

• The PICO(T) Model: This is a framework that helps clinicians formulate clinical questions in a structured way. PICO stands for Patient/Problem, Intervention, Comparison, and Outcome, with an optional Time component. By clearly defining these elements, healthcare providers can search for the most relevant evidence to answer clinical questions.
• The Iowa Model of Evidence-Based Practice: This model focuses on integrating evidence-based practices into healthcare settings by addressing both individual patient needs and organizational priorities. It encourages continuous evaluation of care and the application of research findings.
• The Stetler Model: This model focuses on the systematic review and application of evidence in clinical practice. It emphasizes the importance of critical thinking and the need to assess the quality of evidence before implementing it into practice.

IN CONTEXT

Let’s walk through a realistic example of how evidence-based care is developed for managing hypertension (high blood pressure)—a common condition in healthcare.

Step-by-Step Example of Evidence-Based Care for Hypertension

1. Identifying the Clinical Problem

A patient visits their healthcare provider with concerns about high blood pressure. The provider checks the patient’s blood pressure and finds it elevated—this is the clinical problem that needs addressing.

2. Asking the Right Clinical Question (PICO Framework)

The healthcare provider formulates a clinical question using the PICO framework to guide their search for evidence:

• P (Patient/Problem): Adult patients with hypertension.
• I (Intervention): Medications like ACE inhibitors or lifestyle changes, such as diet and exercise.
• C (Comparison): Comparison with other treatments, such as beta-blockers or lifestyle interventions alone.
• O (Outcome): Reducing blood pressure and preventing complications like heart disease or stroke.

The question could be: "In adults with hypertension, do ACE inhibitors reduce blood pressure more effectively than beta-blockers or lifestyle changes alone?"

3. Searching for Relevant Evidence

The provider then searches for the best available evidence on managing hypertension. This search includes:

• Systematic reviews and meta-analyses (top of the evidence hierarchy) that compare different medications and lifestyle interventions.
• Randomized controlled trials (RCTs) that show how specific medications affect blood pressure over time.
• Cohort studies or clinical guidelines from reputable organizations like the American Heart Association (AHA) that outline the most effective treatments for hypertension.

4. Appraising the Evidence

Once the provider gathers the evidence, they critically evaluate the quality and relevance of the studies. For example, if the studies show that ACE inhibitors significantly lower blood pressure compared to beta-blockers, the provider will look at the size of the effect, whether the trials were well conducted, and if the evidence supports the use of ACE inhibitors as a first-line treatment.

5. Making the Decision (Integrating Evidence With Clinical Expertise)

After evaluating the evidence, the healthcare provider combines this information with their own clinical expertise and knowledge of the patient. For instance:

• The provider might find that ACE inhibitors are effective in lowering blood pressure and are generally well tolerated by most patients.
• They might also consider the patient’s preferences, such as their desire to avoid certain side effects or whether they are willing to make significant lifestyle changes.
• If the patient has additional risk factors (like diabetes), the provider may prioritize certain treatments over others based on the evidence that ACE inhibitors are beneficial for hypertensive patients with diabetes.

6. Considering Patient Preferences

Evidence-based care also emphasizes shared decision making. The provider discusses the evidence with the patient, explaining the pros and cons of each treatment option. The patient’s preferences are considered—some patients may prefer to start with lifestyle changes first, while others may want to begin medication to address the issue immediately.

For example, a provider may offer the following options:

• Start with lifestyle changes, like reducing salt intake, exercising, and losing weight, and monitor the blood pressure for 3–6 months.
• Or, begin medication with an ACE inhibitor (based on evidence of its effectiveness), alongside lifestyle changes.

7. Implementing the Treatment Plan

The provider and patient agree on the best approach. The healthcare provider prescribes an ACE inhibitor and encourages the patient to adopt healthier lifestyle choices, such as exercising and eating a balanced diet rich in fruits and vegetables. They set up regular follow-up appointments to monitor the patient’s blood pressure.

8. Evaluating the Outcomes

After a few months, the provider checks the patient’s blood pressure again. The patient’s readings have improved significantly due to the medication and lifestyle changes. The healthcare provider reviews the outcomes based on the established evidence: ACE inhibitors effectively lowered the patient's blood pressure, and the lifestyle modifications contributed to better health.

If the patient’s blood pressure doesn’t improve as expected, the provider may adjust the treatment plan, such as trying a different medication or offering additional support for lifestyle changes. They continue to rely on the evidence to guide adjustments to care.

Through this process, the patient receives the most effective care available based on the latest research, and their individual needs and preferences are respected, leading to improved health outcomes. This example shows how evidence-based care ensures that treatments are not only scientifically sound but also personalized to the patient’s situation.

watch

In this video you will learn how evidence-based practice helps healthcare professionals deliver safer, more effective care by using the latest research and best available evidence.