Variations in physician practice are well documented, despite the existence of best practices. Difficulty in translating research inlc practice, as well as industry influence, may be factors responsible for such variation. For academic medical centers (AMCs), this may lead to inefficiencies, resulting in lesser quality patient care and opportunity costs, such as the inability to reinvest in education, research, and patient care.
To support the quality, safety and cost effectiveness of patient care, the AMC created a Center for Evidence‐Based Practice (CEP) designed lo summarize scientific evidence for AMC decision making about clinical policy.
CEP opened in July 2006, is funded by the AMC chief medical officer, and is staffed by 2 hospitalist codirectors trained in epidemiology, 2 health technology assessment (HTA) analysts, primary care and infectious disease physician liaisons, a librarian, a health economist, and an administrator, totaling 4.5 full time equivalents. Approximately 100 reports (guidelines, standalone evidence reviews, and short advisories) have been completed to date for medical, nursing, and administrative leaders, as well as standing and ad hoc committees (e.g., anticoagulation task force). Topics have included lower‐cost practices, like the use of heparin versus saline for catheter flushing, to higher‐cost and emerging technologies, like the use of lelemedicine in critical care. Reports review existing guidelines and systematic reviews first, and review primary studies only when previously published reviews are not sufficient. Local utilization and cost data are incorporated so reports can be tailored to the AMC. CEP then works with key stakeholders to implement reports, including integrating them into computerized decision support or quality initiatives, and measures their impact using administrative or clinical data. Evidence reviews are shared publicly through the National Guideline Clearinghouse (n = 3), the Cochrane indexed Centre for Reviews and Dissemination HTA Database (n = 58), peer‐reviewed publications n = 6), and conference abstracts (n = 4). CEP also offers education through workshops (n = 10), an elective for residents (n = 14 participants), faculty CME, and academic detailing. In addition, CEP has developed collaborations with pharmacology, payers, and government organizations on issues relevant to the AMC, such as the development of infection control guidelines wilh the CDC.
A small center funded by an AMC can offer systematic evaluations of “high‐impact” clinical issues. in addition, such evaluations can promote a culture of evidence‐based decision making, offer educational and publishing opportunities, and facilitate constructive relations between the AMC and outside organizations.
C. Umscheid, none; M. Mitchell, none; K. Williams, none; P. Brennan, none.
To cite this abstract:Umscheid C, Mitchell M, Williams K, Brennan P. The First 3 Years of a Hospital‐Based Comparative Effectiveness Center; Translating Research into Practice to Improve the Quality, Safety, and Cost Effectiveness of Patient Care. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 199. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/the-first-3-years-of-a-hospitalbased-comparative-effectiveness-center-translating-research-into-practice-to-improve-the-quality-safety-and-cost-effectiveness-of-patient-care/. Accessed May 26, 2019.