Evidence synthesis activities of a hospital evidence-based practice center and impact on hospital decisionmaking.

Jayakumar KL1, Lavenberg JA2, Mitchell MD2, Doshi JA2,3,4, Leas B2, Goldmann DR2,3, Williams K2,3, Brennan PJ2,3, Umscheid CA2,3,4,5,6,7.

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Abstract

BACKGROUND:

Hospital evidence-based practice centers (EPCs) synthesize and disseminate evidence locally, but their impact on institutionaldecision making is unclear.

OBJECTIVE:

To assess the evidence synthesis activities and impact of a hospital EPC serving a large academic healthcare system.

DESIGN, SETTING, AND PARTICIPANTS:

Descriptive analysis of the EPC's database of rapid systematic reviews since EPC inception (July 2006-June 2014), and survey of report requestors from the EPC's last 4 fiscal years.

MEASUREMENTS:

Descriptive analyses examined requestor and report characteristics; questionnaire examined report usability, impact, and requestor satisfaction (higher scores on 5-point Likert scales reflected greater agreement).

RESULTS:

The EPC completed 249 evidence reviews since inception. The most common requestors were clinical departments (29%, n = 72), chief medical officers (19%, n = 47), and purchasing committees (14%, n = 35). The most common technologies reviewed were drugs (24%, n = 60), devices (19%, n = 48), and care processes (12%, n = 31). Mean report completion time was 70 days. Thirty reports (12%) informed computerizeddecision support interventions. More than half of reports (56%, n = 139) were completed in the last 4 fiscal years for 65 requestors. Of the 64 eligible participants, 46 responded (72%). Requestors were satisfied with the report (mean = 4.4), and agreed it was delivered promptly (mean = 4.4), answered the questions posed (mean = 4.3), and informed their final decision (mean = 4.1).

CONCLUSIONS:

This is the first examination of evidence synthesis activities by a hospital EPC in the United States. Our findings suggest hospitalEPCs can efficiently synthesize and disseminate evidence addressing a range of clinical topics for diverse stakeholders, and can influence localdecision making. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine.