Uniformity in care provision forms the backbone of health systems’ strategies aimed at improving patient outcomes and streamlining operational efficiency. However, aligning physicians with evidence-based practices can become a formidable task, particularly when it requires a shift from traditional training methods. Dr. David Christensen, Senior Vice President of Medical Affairs and Chief Physician Executive at Valley Children’s Healthcare in Madera, California, highlights the treatment of bronchiolitis as an illustrative example. This common viral infection, which primarily affects young children by targeting smaller airways in the lungs, has traditionally been treated with steroids, antibiotics, and bronchodilators, along with chest X-rays for diagnosis.
In contrast to the established treatment protocols, in 2006, the American Academy of Pediatrics advocated for a shift towards less intensive diagnostic procedures and fewer medications in their published evidence-based practice guidelines. Supported by an ever-increasing body of evidence, the guidelines proposed diagnosing bronchiolitis based on patients’ medical history and physical examinations, insisting that supportive care should constitute the primary treatment. Data indicated that more complex treatment and management offered little to no benefit for the majority of patients.
Dr. Christensen concurred with these new methods stating, ‘This is a complete departure from the training we received years ago.’ He added that this approach not only benefits the patient but also proves cost-effective. It spares the child from unnecessary exposure to radiation and antibiotic use, ultimately saving the healthcare system and society at large from the financial burden of unnecessary testing and medication.
However, gaining clinician acceptance of the new guidelines was an incremental process, particularly among experienced practitioners. Initial attempts to incorporate these evidence-based protocols into the Electronic Health Record (EHR) system for managing bronchiolitis encountered resistance from physicians who perceived it as an encroachment on their clinical autonomy. Over time, however, consistent communication, advocacy of updated guidelines, and a clear explanation of the value the protocols brought to patient care led to a perceptual shift. Today, these protocols are embraced and considered a standard practice in bronchiolitis treatment. ‘Over time, as we continue to present the robust evidence supporting these protocols, physicians have slowly started to accept and implement these order sets,’ observed Dr. Christensen.
Looking forward to 2022 and beyond, the alignment of health professionals and system executives across various departments is identified as crucial to organizational success. As health systems continue to evolve, the adoption of evidence-based practice holds the key to providing more effective and efficient patient care.
Source: https://www.beckershospitalreview.com/quality/the-key-to-evidence-based-care-alignment-per-1-cmo/