Evidence-Based Practice Centers Can Reduce Costs, Errors

Until now, the impact of evidence-based practice centers (EPCs) on hospital decision making has been relatively unclear—but new data from Penn Medicine researchers suggest that hospital EPCs can accurately distribute clinical evidence and are useful in influencing the stakeholder decision-making process.

The findings come from University of Pennsylvania’s Penn Medicine Center for Evidence-Based Practice (CEP)’s recent analysis of its own EPC, the first examination of evidence synthesis activities by a hospital EPC in the United States.

The center—staffed by a hospitalist director, research analysts, physician and nurse liaisons, a health economist, a biostatistician, administrator, and librarians—regularly conducts rapid systematic reviews of published research to create evidence-based reports for hospitals to follow.

“By synthesizing this valuable data, EPCs can inform healthcare leaders on how to make decisions that improve care, cut costs, and achieve other positive changes throughout their operations,” Craig A. Umschied, MD, MSCE, director of CEP and senior author of the study, said in a press release.

This latest study comprised a descriptive analysis of the center’s review database from its inception in July 2006 to June 2014, followed by a questionnaire of those who requested reviews from its last 4 fiscal years. Requestors included clinical departments, chief medical officers, and purchasing committees—and requests covered reviews of everything from care processes, organizational systems, and policies to medical and surgical procedures. Evaluations of drugs and devices were the 2 most commonly requested topics.

Using a 5-point Likert scale to indicate level of agreement/satisfaction, the questionnaire found that most requestors found their reviews prompt, accurate, and helpful. Nearly all (98%) of the 46 respondents said the scope of their requested reviews and level of detail was “about right,” and 77% said the reports confirmed their tentative decision. Furthermore, 79% “agreed” or “strongly agreed” that the report informed their decision. Respondent satisfaction was also high, as most stated that reports from the CEP were “easy to request, easy to use, timely, and relevant.” Finally, 10% of reports even went on to be used in developing modules in the hospital’s electronic health record.

Through efforts to optimize patient care, hospitals have long been tenacious in their search for solutions and the results of this study suggest that the answer may indeed lie in EPCs. The findings hint at a step toward standardizing the use of evidence-based care strategies in healthcare institutions in the future.

"[With the creation of the Center,] we wanted to create a forum to develop clinical practices and policies that would span the whole health system," P.J. Brennan MD, chief medical officer of the Penn health system, said. "The ultimate goal is to significantly improve patient safety and clinical outcomes."