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Evidence Informed Best Practice. Dr. Richard Volpe Professor and Projects Director Life Span Adaptation Projects University of Toronto 45 Walmer Road, Toronto, Ontario, Canada email: [email protected] April 24, 2007. Evidence-Based Practice.

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Evidence informed best practice

Evidence Informed Best Practice

Dr. Richard Volpe

Professor and Projects Director

Life Span Adaptation Projects

University of Toronto

45 Walmer Road, Toronto, Ontario, Canada

email: [email protected]

April 24, 2007


Evidence-Based Practice

“the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” requiring the “integration of best research evidence with clinical expertise and patient values” (Sackett, 2000)


Evidence based decision making ebdm

Evidence-Based Decision Making(EBDM)

“The systematic application of the best available evidence to the evaluation of options and to decision-making in clinical, management and policy settings.” (Prime Minister’s National Forum on Health in 1997)


The challenge of evidence based practice to injury prevention

The Challenge of Evidence-Based Practice to Injury Prevention

Nature of Evidence

Shortage of Evidence


Onf strategic funding initiative

ONF Strategic Funding Initiative

Implement an evidence-based injury prevention practices in Ontario.

Evaluate their effectiveness and potential in reducing the incidence of head and spinal cord injury.

To assist communities and other interested stakeholders to go forward after the implementation evaluations and to secure long-term funding.

Determine policy impact and implications of implementations.

Inform and make recommendations to the provincial government and other stakeholders on the feasibility of this strategic initiative and any implications for future directions.


Objectives of the onf best practice reviews

Objectives of the ONF Best Practice Reviews

Survey the range of neurotrauma prevention strategies and programs.

Identify examples of effective, evidence-based practice.

Describe, analyze and evaluate these in terms of their effectiveness for diverse age groups.

Develop and strengthen networks by mobilizing public support and encouraging the participation of stakeholders.

Provide a casebooks of exemplary, evidence based neurotrauma prevention efforts.

Create a means of distributing the casebooks, resource documents and field contacts.


Best practice nomination
Best Practice Nomination

  • Theoretical relevance (capable of conceptual elaboration)

  • Inclusion of at least three of the five Es (Education, Enactment, Engineering, Economics, Evaluation)

  • Life span orientation

  • Exhibition of innovative and effective strategies

  • Employment of mixed research methods and perspectives (triangulation)

  • Availability of sufficient documented evaluation research information

  • Strong evidence for the reduction of incidence

  • Replicability and adaptability

  • Effort to address communication and dissemination issues


Knowledge transfer

Knowledge Transfer:

Systematic Reviews

Compendium of Effective, Evidenced Based Practices In the Prevention of Neurotrauma

Preventing Neurotrauma: A Casebook of Evidenced Based Practices

Road Safety Review

Source book of Evidenced-Based Practices in the Prevention of Severe Injuries

Science and Sustainability in Injury Prevention

Preventing Severe Sports injuries


New south wales
New South Wales

Stay On Your Feet (SOYF)

Senior Falls Prevention


Soyf in ontario
SOYF in Ontario

  • Implement the SOYF Program in 3 trial communities

  • Evaluate its effectiveness in reducing senior falls across the three communities

  • Evaluate effectiveness of the program in the province

  • Determine the feasibility of implementing the mutifaceted intervention within Ontario

  • Determine policy impact and implications to seniors falls

  • Inform and make recommendations to the provincial government and other stakeholders on feasibility



ONF Shaken Baby Syndrome Prevention Program

Ontario

Best Start Resource Centre

North Bay

North Bay General Hospital

North Bay Public Health

CCPIP

Midwives of North Bay

Sudbury

Sudbury General Hospital

Sudbury Public Health

Midwives of Sudbury

Kingston

Better Beginnings

Public Health

Mississauga

Credit Valley Hospital

Oshawa

Lakeridge Health Centre

Hamilton

McMaster University

Public Health Services – Healthy Babies

Toronto

University of Toronto

Life Span Adaptation Projects

Institute of Child Study, OISE/UT




Sustainability scale
SUSTAINABILITY & SCALE Prevention- North Bay, Ontario


The challenge of evidence based practice to injury prevention1

The Challenge of Evidence-Based Practice Prevention- North Bay, Ontarioto Injury Prevention

Nature of Evidence

Shortage of Evidence


Evidence and action evidence and prevention

Evidence and Action Prevention- North Bay, OntarioEvidence and Prevention


Identified knowledge domains of public health

Identified Knowledge Domains Prevention- North Bay, OntarioofPublic Health

Maternal & Child Health

Public Health Nursing

Disaster Control & Emergency Services Communicable Diseases HIV/AIDS Nutrition Chronic Diseases & Conditions Public Health Laboratory Sciences Public Health Informatics Global Health

General Public Health Epidemiology Biostatistics Vital Statistics & Surveillance Environmental Health Occupational Health Health Services Administration Social & Behavioral Sciences Health Promotion & Education Community Health


The life space

Socio-cultural Prevention- North Bay, Ontario

Interpersonal

Language

Secondary

Relationship

Values

Primary

Relationship

Norms

Artifacts

(man-made

objects)

Cognition

Biochemical

Processes

Natural

Objects

Physical Environment

Internal States

Genetic

Processes

The Life Space


We know enough

We Know Enough: Prevention- North Bay, Ontario

Injuries are not the result of accidental events but are predictable.

Risk factors are identifiable and modifiable.

Risk factors can substitute for understanding causes.

Risk factors also point to protective factors.

More than one risk factor usually needed to bring about an adverse outcome.

More than one positive factor usually needed to produce a positive outcome.


Injury prevention as change in complex systems

Injury Prevention Prevention- North Bay, Ontarioas Change in Complex Systems

Life span transformations in individuals and groups that emerge in the process of adaptation.


Evidence informed practice

Evidence Informed Practice Prevention- North Bay, Ontario


Wisdom
Wisdom Prevention- North Bay, Ontario

“A wise person is one who uses his or her successful intelligence in order to seek a common good, by balancing intrapersonal, interpersonal, and extrapersonal interests; over the short and long terms; through the infusion of values; in order to adapt to, shape, and select environments.”

(Sternberg, 1990)


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