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C1O4 | Evidence-based medicine training: reaching the front line clinician in an integrated medical care system

Abstract text
Background: A shared language surrounding assessment of medical literature and translation into evidence-based practice is central to providing high quality, coordinated, outcomes-based medical care. There are few structured evidence-based medicine (EBM) training programs targeting front line clinicians in a community setting. A large regional medical group (>400 physicians) embraced a program promoting a system-wide culture of EBM. EBM foundations training was developed to provide reinforcement through hands-on experience and system-wide dissemination through a regional grand rounds program.

Objective: To create a culture of evidence-based practice (EBP) in a single health care system through integration of an evidence-based foundations training course into a regional grand rounds program.

Methods: A four-hour interactive training session targets the principles of EBM and EBP during grand rounds content development. Further EBM support is provided at follow-up sessions. In the grand rounds program, presenters must provide a rationale for key clinical recommendations by synthesizing the best available evidence using standard formats for evidence and recommendation grading. Physician clinics close for grand rounds, consistent language for medical evidence is used system-wide, and intranet posting reaches about 2000 health care professionals.

Results: Since 2009, there have been 51 course participants, including physicians and allied health professionals. Grand rounds attendance averages 57 % of the medical group. To date, over 68 graded recommendations were made across 21 clinical topics. Course evaluations show high satisfaction and achieved course objectives. Grand rounds participant evaluations demonstrate clarity of the evidence basis for clinical recommendations (96 % positive response). Improved outcomes measures from specific recommendations can be demonstrated as part of a broader multi-faceted process of which EBP is an important component.

Conclusion: A structured, interactive EBP training program integrated into a regional grand rounds program can successfully reach front line clinicians and advance evidence-based culture throughout a health care system.
Ching K1, Regidor D2, Okawa G1
1 Hawaii Permanente Medical Group, US
2 Kaiser Permanente Care Management Institute, US
Presenting author and contact person
Presenting author: 
Karen Ching
Contact person: 
Karen Ching (Contact this person)
Date and Location
Oral session C1O4
Thursday 20 October 2011 - 12:25 - 12:45