Objective: Outline the importance of incorporating evidence based practice into perfusion. In a classroom like setting with open feedback from attendees, we will explore a variety of implications of adopting such practice patterns both clinically and professionally.
Looking at clinical practice through the “evidence based lens” has become popular notion for healthcare professionals and healthcare organizations. Likosky’s invited editorial, published in the Journal of ExtraCorporeal Technology earlier this year, provides an overview for evaluating evidence for the perfusionisti. It just makes sense to measure the care that we provide against what has been published in the medical literature. The absence of good evidence in some aspects of care, will guide some to develop a hypothesis and conduct research in an effort to create new knowledge where evidence is lacking. In addition to the internal motivation to embrace practices that are evidence based, there are increasing external pressures that will drive the EBM movement. The Institute of Medicine report, “Crossing the Quality Chasm” introduced an awareness of the need for transparency in healthcareii. The result has been an avalanche of quality reports—in print and on the Internet—from regulatory agencies, accrediting bodies, statewide organizations, business coalitions, employers, and commercial health care “scorecard” vendorsiii. EBM is a main focus of the United States Department of Health and Human Services Centers for Medicaid and Medicare Services’ (CMS) “Pay for Performance Initiative”. Hospitals that are able to hit quality targets and are able to document their adherence to evidence based practices will receive a higher reimbursement from CMS. These initiatives have been rolled out by Diagnostic Related Groups (DRGs). For example, for Acute Myocardial Infarction, providing aspirin to the patient upon arrival at the hospital, thrombolytic therapy within thirty minutes of arrival at the hospital, and percutaneous intervention within 90 minutes of arrival to the emergency department are the benchmarks. A further object of CMS will be to develop Evidence based guidelines to guide clinicians in providing sound care. The Medical Payment Advisory Committee (MedPAC), a committee of the CMS, wants to leverage the pay-for-performance initiative to encourage hospitals to enhance the development of information technology systems to an electronic medical records platform.
In summary, EBM is coming to you… like now. Not only is it the right thing to do, it is becoming increasingly expected by patients and healthcare agencies. Your Hospital’s performance will increasingly become the subject of public reports. And if that is not incentive enough, adherence to EBM will be a determining factor in the rate at which institutions and physicians will be paid for the services that they provide.
EBM: Coming to Your Practice, Like NowReferencesi Likosky DS. A Primer on reviewing and synthesizing evidence. JECT 38:2:112-115.ii Crossing the Quality Chasm: A New Health System for the 21st Century, Committee on Quality of Health Care in America, INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS, Washington, D.C. ISBN: 0309072808 iii Nelson E, Homa K, Maastraduno M, et al. Publicly Reporting Comprehensive Quality and Cost Data: A Health Care System’s Transparency Initiative. Journal of Quality and Patient Safety. 2005; 31: 573-584. |
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