ebm in innlandet health trust
DESCRIPTION
How can a health trust foster evidence-baced practice? The presentation gives an overview on how a norwegian health trust, in a region with 400 000 inhabitants, systematically works to get new knowledge into practice.TRANSCRIPT
EBM in Innlandet health trust
• Overall strategy
• Action plan 2010
• Challenges
Innlandet Health Trust
• 390 000 inhabitants
• 2 counties
• 9 hospitals
• 41 units all in all
• only specialist services
2
Innlandet Health Trust
8427 employees
Ann. budget CAD 1 bn
1301 beds
3
Strategy in the trust: Core components
• Find and create perceived needs
• Build on existing structures and processes
• Evidence-based knowledge support systems
• Create good examples
Overall strategy• Involvement of leaders
• Clinical councils
• Permeation in strategies
• National and regional support
• Cultivating networks
• Mass media
• Action plans
Leadership and clinical councils
• Weekly leader meetings
• Trust strategies
• Trust board
• Challenges to councils
National and regional support• Employees in SI
extensively involved
• Pilot projects in SI– i.e. procedures
• Influencing the regional authorities– i.e. care pathways
Fostering networks
• Social media
• Radical transparency
• Department + friends
Mass media
Action plan 2010
Teaching EBM
Teaching the clinical staff EBM
• Lectures and courses
• Plan, do, study, act
• Work files
• Building EBM education into the hospital structures
• Champions to/from national conference
Our practice-what we tell ourselves to do
Clinical care pathways• Order from regional
health trust
• Using AGREE tool in development
• Evidence-based implementation
• Initiatives to improve user interface
Best practice – best process – best results
New interface
Role-based filtering
Phase-based filtering
One-click to in-depth information
Evidence-based procedures & guidelines
The challenge:
• 6000 procedures in SI
• 4000 outdated
• Most are local
• User interface sub-optimal
• No transparency of method
Evidence-based procedures & guidelines
The ”CEPI” project
• Common...
• evidence-based...
• procedures...
• on the internet...
Evidence-based procedures & guidelines
Evidence-based procedures:
• support to councils
• AGREE tool
• transparent methodology
• national initiative
Nursing care plans
• 120 finished
• AGREE tool
• better quality
• better documentation
• Learning tool
Handbook of implementation• EPOC and NIRN
• checklists
• tools
• Demand outside of trust
EBM library services
EBM librarianship
Librarians educated in EBM
Literature searches based on 6S model care plans procedure care pathways
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EBM webpage for clinicians
Learning tools Tools for making and
implementing practice Litterature searches The Egg Tests in information
literacy Implementation
handbook
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Access to knowledge sources• Map of Medicine?
• UpToDate
• NEL?
• PPS?
The knowledge egg
• 6S model as the base
• In collaboration with McMaster/HIRU
• Meant for the Norwegian El. library
• 2.0 version ready for launch
Use of UpToDate before and after the Egg
EBM research
EviCare• “Evidence-based
practice in clinical decision support systems”
• A research program in the VerdIKT program of the Norwegian Research Counsil
EviCare
Knowledge and prototypes
Journal in collaboration with the Norwegian Health Library
• Mental health only
• 1200 subscribers
• Short news articles based on feed from McMaster PLUS
• ++