Evidence Based Practice
Evidence Based Practice
The Department of Evidence Based Practice (EBP) promotes evidence-based and high-value care throughout Children’s Mercy Kansas City and the greater pediatric community by developing care standardization decision support tools and resources based on scientific literature. These products improve patient outcomes and safety, while also increasing medical team efficiency and decreasing unwarranted variation in care.
Clinical decision support tools
View our CPGs, CPMs, and ERAS
Clinical Practice Guidelines (CPGs) are intended to standardize patient care. Our guidelines are informed by the systematic review of current pediatric health care literature and includes risk and benefit assessment of alternative care options.
Care Process Models (CPMs) are also intended to standardize care; however they are developed by consensus agreement from subject matter experts when explicit literature is not available or is weak.
Enhanced Recovery After Surgery (ERAS) pathways promote an evidence based, multidisciplinary approach to patient care aimed at facilitating faster recovery from surgery, decreasing hospital length of stay, and minimizing post-operative complications.
Critically Appraised Topics
Critically Appraised Topics (CATs) synthesize literature that answer single questions related to a focused clinical care concern, patient safety issue, or a supply chain initiative.
Team qualifications
Our department, a multidisciplinary team with specialized expertise in EBP methodology, narrows the gap between research and clinical practice. Each member of our department maintains multiple credentials and proficiencies.
- Completion of McMaster’s University “International Guideline Credentialing Certification Program” Level 1 or higher.
- Extensive experience in systematic appraisal of diagnostic and therapeutic studies, including but not limited to randomized control trials, cohort, case-control, case series, and case studies.
- Proficient in evidence-based practice methodology, including but not limited to:
- Population/Intervention/Comparison/Outcomes (PICO) question development.
- Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
- Lucidchart (online collaborative tool for flow diagram development).
- Rayyan (online collaborative tool to organize literature for systematic reviews or meta-analysis).
- Cochrane Collaborative Review Manager.
- Grading of Recommendations Assessment, Development and Evaluation (GRADE) Guideline Development Tool.
- GRADE Evidence to Decision (EtD) Framework.
- Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) diagrams.
How our team works
The Department of EBP relies on the expertise of Children’s Mercy medical professionals to assist in the development of decision support tools and resources. A multidisciplinary committee is assembled for each Clinical Practice Guideline (CPG), Care Process Model (CPM), and Enhanced Recovery After Surgery (ERAS) pathway. These committees can rely on the Department of EBP to support them.
- Attend and co-lead each committee meeting with the committee chair.
- Manage meeting schedules, agendas, and minutes.
- Conduct an in-depth literature review to assess the quality and relevance of existing evidence and/or clinical guidelines.
- Coordinate literature searches based on PICO questions developed by the Committee with the Medical Librarian.
- Submit identified studies to Rayyan and provide instructions to committee members on its use.
- Critically appraise literature and clinical guidelines with the assistance of the EBP Scholars utilizing Review Manager (RevMan) and Appraisal of Guidelines for Research and Evaluation (AGREE II), respectively.
- Employ GRADE Evidence to Decision framework and Guideline Development Tool to guide decisions and recommendations.
- Develop and review literature synopses with the committee.
- Help navigate the differences between evidence-based recommendations and best practices specific to our institution.
- When differences in clinical opinions arise within the committee, EBP will facilitate discussion(s) to garner group consensus.
- Assist in developing metrics related to global aims.
- Create the text of the CPG/CPM/ERAS synopsis based on the above EBP strategies for committee review.
- Identify at least two reviewers (internal and external) to evaluate the quality of the CPG algorithm and care standards using the AGREE II instrument.
- Format algorithms to serve as decision support tools within the CPG/CPM/ERAS.
- Collaborate with Parent Experience, Simulation, Human Factors, Quality Improvement, Patient Safety, and others as needed to assist with product implementation.
- Assist the team and medical informatics in creating or updating order sets and other EMR tools needed for product implementation.
- Publish the CPG/CPM/ERAS on ChildrensMercy.org.
- Address any conflicts of interest.
- Promote the new product as needed (e.g., Children's Mercy E-News, The Link)
- Collaborate as co-authors with committee members in developing academic products, if any.
- Serve as project champion when communicating with institutional leaders.
- Arrange for updates to CPGs at least every three years, CPMs at least every two years, and ERAS pathways at least annually.