From the Page to the Patient: A Critical Analysis of the Policy Issues Associated with Translating Evidence into Evidence-Based Practice
Public Deposited- Last Modified
- April 23, 2020
- Creator
-
Muchiteni, Tshaka
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Although most people today assume that evidence-based medicine has had a significant effect on improving certain aspects of health care quality, it is also clear that evidence-based medicine has yet to reach its full potential and still has quite a bit of room to grow. Unfortunately, the principle that served as the foundation of evidence-based medicine has not lived up to its original promise. In this paper, I examine guideline implementation programs with the intention of identifying the underlying characteristics that contribute to their success and exploring ways in which these values can be adapted in the future. First, I briefly discuss the historical context of evidence-based medicine, its original intention, and how that perception has changed over time. This discussion presents the three-step process of practicing evidencebased medicine: developing systematic reviews; creating clinical practice guidelines; and implementing those guidelines in clinical practice. It addresses the barriers impeding the process and shows how guideline implementation programs dismantle those obstacles. Second, the paper delineates the treatment gap between best practice defined by research evidence and actual clinical practice and it illustrates the gap by looking specifically at beta-blocker use in the secondary prevention of myocardial infarction. The analysis shows that guideline implementation programs targeted to increase the use of beta-blockers in myocardial infarction patients appear to be related to more evidence-based practice and, through that improved practice, on better health outcomes. The literature suggests that general data feedback, clinical care coordinators, and clinical education are associated with successful guideline implementation programs. Programs designed to reach multiple hospitals benefit from simultaneous use of a wide variety of implementation supports. Smaller programs, on the other hand, benefit from goal-directed designs focusing on a few key components tailored to their particular needs. The paper concludes with implications for research, ongoing program development, future policymaking, and the success of evidence-based medicine in general.
- Date of publication
- May 2007
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Track: HC&P
- Paper type: Research or research design
- Advisor
- Tolleson-Rinehart, Sue
- Reviewer
- Kissinger, Linda
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2007
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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