April 20, 2011
I just read a wonderful article that brought together something that has been dancing around in my mind lately. Can evidence-based medicine and clinical quality improvement learn from each other? by Paul Glasziou, Greg Ogrinc, and Steve Goodman offers some intriguing insights. Additionally, the timing could not be more perfect.
My studies pertaining to evidence-based medicine (EBM) in school right now have experienced many close encounters with my quality / performance / process improvement background. Certainly providing best practice is part of quality care, but as the authors point out, ‘doing the right thing’ and ‘doing things right’, while complementing one another, are not quite the same.
Thanks to technology, identifying what needs to be done in clinical practice is now the easy part. Determining how to disseminate that practice among multiple providers, disciplines, and settings is trickier. Established processes within health care systems may prevent ‘right things’ from being accomplished correctly, consistently – or at all. The implementation of EBM may require the employment of quality improvement methods to integrate evidence into individual clinical practice and entire systems of care.
However, while EBM and QI look like a team destined for great things, I cannot help but think the potential for incredibly awesomeness is being overlooked. Adding Patient Safety and Informatics to this team provides a multidimensional balance and comprehensive structure that addresses a multitude of interdependent, overlapping, and mutually beneficial concerns. This group of professionals would have the ability to predict, prevent, implement, and evaluate barriers to providing the highest quality of care.
Maybe then we will have the best chance of ‘doing the right thing right’– for all patients all of the time.
BMJ Quality and Safety 2011 at http://qualitysafety.bmj.com/content/20/Suppl_1/i13.full