What is EBP?
“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett et al, 1996)
Evidence-based practice (EBP) means using the best, research-proven assessments and treatments in our day-to-day client care and service delivery. This means each clinician undertakes to stay in touch with the research literature and to use it as a part of their clinical decision making. EBP also means weighing the value of each part of the research evidence with clinical data and informed client choice. In other words, we need to know what the research says, share this knowledge in an unbiased way with our clients, and with those clients make decisions about care based on our evaluation. To be accountable for our EBP we should record both the decisions made and the evidence we used. Following such decisions, an EBP clinician will also collect data to show that the clinical decision is helping address the client’s goals.
EBP relies on clinicians understanding and evaluating the available research evidence and their own practice. To evaluate all the evidence would be a time consuming process and therefore a systematic approach to interpreting the research is required. This might include being a member of a journal club, an EBP interest group or using speechBITE to evaluate the treatment literature.
Using EBP means giving the best possible care to our clients and letting go of old or ineffective practices when a different way is possible and shown to be effective. It means choosing client focussed service delivery and being able to explain why we should do it that way, rather than being compelled to use budget conscious service delivery because we can’t prove our treatments are effective.
What does the EBP process involve?
There are a number of EBP processes which have been developed to help clinicians implement EBP in the workplace and a number of EBP websites which explain the steps involved.
The most common procedure follows 6 steps:
- Formulate a clinical question
- Search the literature
- Sort, read and critique the literature
- Come to a “clinical bottom line”, in other words recommendations for day-to-day practice based only on the best available literature.
- Implement the recommendations, documenting them, any changes you choose to make and the outcomes of your intervention. In implementing the recommendations you apply the research to your clinical setting and client. You need to include your client and the service provider in this implementation process. In other words, apply the evidence to the situation in consultation with those who it will affect.
- Share the results of your EBP with others, ideally through writing them up.
Although traditionally EBP training emphasised accessing and appraising the research evidence, recently there has been a drive to increase clinician awareness of the three components of the EBP process (research evidence, clinical data and informed client choice). This has led to the term E3BP being introduced to reflect these three essential components (Dollaghan, 2007).
There are also a range of online EBP resources available to make the process easier, including already published systematic reviews, critically appraised papers (CAPs) and critically appraised topics (CATs).
How does speechBITE help in the EBP process?
speechBITE aims to reduce the time and challenges associated with accessing and appraising the research evidence in order to make EBP easier for all clinicians. We’ve done this by searching, indexing and rating the quality of 1000’s of treatment papers for you.