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DAY (3)

DAY (3). Session 1 What are your health care challenges?. Learning objectives. To identify challenges to getting EBRHC into practice and policy. To generate ideas for getting EBRHC into practice and policy. Challenges and opportunities.

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DAY (3)

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  1. DAY (3) Session 1 What are your health care challenges?

  2. Learning objectives • To identify challenges to getting EBRHC into practice and policy. • To generate ideas for getting EBRHC into practice and policy.

  3. Challenges and opportunities • Discuss and write down the 3 most important challenges which currently prevent you from practicing EBRHC. • Discuss and write down 3 feasible ways in which you could meet these or other challenges and practice EBRHC. • (use your own clinical practice, academic setting or policy-making situation to inform the above)

  4. Challenges to the implementation of EBRHC • lack of evidence • lack of access to evidence • evidence conflicts with expert/political agenda • lack of will at senior level • too costly • evidence disputed by lobbyists • evidence not timely • evidence not in a useful format

  5. Challenges to EBRHC • “so busy applying this new methodology . . . that (they) no longer have time to see patients.” Grahame-Smith D. Evidence based medicine: Socratic dissent. BMJ. 1995;310:1126-7.

  6. How to promote EBRHC • If evidence is available: • check local transferability • integrate into existing policy • shift to “epidemiological culture”

  7. How to promote EBRHC • If evidence is not available: • evaluate promising interventions • government commitment to research and capacity building • government support for access to information, e.g. establish national clearing house.

  8. What we always knew… • “Evidence-based medicine is just another factor, along with the patient, the practice environment, and the clinician, that affects medical decision-making. The collation and interpretation of all these factors used to be known as clinical judgement and is still required everywhere.” Grace R, Everard L. Where to practise evidence-based medicine? Lancet. 2001;357(9257):723

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