Physical therapists Amy Krahe and Lori Ross jumped at the chance to attend an onsite evidence-based practice (EBP) immersion workshop led by expert faculty from The Helene Fuld Health Trust National Institute for Evidence-Based Practice.
“EBP is common in the nursing world, but it’s less common in other clinical areas,” said Lori. “When the hospital’s interdisciplinary EBP committee organized the immersion workshop they wanted to include people outside of nursing to help staff develop the knowledge needed to implement an evidence-based approach to practice and decision-making in their departments.”
Amy says the workshop taught her how to examine evidence to create meaningful practice changes to improve patient outcomes, increase staff and patient/family satisfaction and decrease costs for the organization. Both women say the workshop taught them to change the way they think about patient care.
“In rehabilitation services, our process decisions were often based on one or two journal article findings,” said Lori. “It’s hard to make a sound clinical decision to change a protocol based off one journal article.”
Lori and Amy, now considered EBP mentors, met with each department within rehab to share a mini training session about EBP.
“The basis of EBP is questioning,” said Lori. “We wanted each area to come up with a clinical question whether it was how they treat an ACL tear to how they schedule patients.”
“After developing a question, each department was asked to research it, find out what evidence already existed, make recommendations for changes, or confirm they were already doing the right thing,” said Amy. “If staff can’t come up with an answer to their question, they may be the ones performing the research that helps standardize our care.”
The physical therapy department’s question dealt with shared inpatient/outpatient staff scheduling and whether it was inefficient.
“The department wanted to examine if it was better for continuity of care if the patient saw the same therapist as much as possible,” said Lori. “They examined the literature and studies showed that seeing the same staff members improved patient satisfaction. When they dug a little deeper, they found their inpatient physical therapy visits were lacking this continuity of care and it was time to make a change.”
After examining current evidence, the next step involved surveying what other hospitals were doing and discovering what was considered best practice.
“An EBP clinician integrates the evidence from research with clinical expertise and patient preferences to determine best practice,” said Amy. “And, even once a best practice has been established, it’s important to re-examine it.”
That’s exactly what the audiology department decided to do.
“Audiology had been prescribing hearing aids to kids with mild to moderate hearing loss as soon as they were identified because studies showed even a mild or partial hearing loss can affect a child’s ability to develop speech and language properly,” said Lori. “Staff looked at the social issues that can result from hearing loss and determined the evidence showed they were already doing best practice in this area.”
The goal is for this spirit of inquiry to become a way of thinking, and not just a project.
“EBP is becoming the standard that will drive health care practice,” said Amy. “We are proud to be a part of an organization that recognizes this and is encouraging all departments to make this a priority as we strive to provide the best care for our patients.”