EBM in Innlandet health trust

• Overall strategy

• Action plan 2010

• Challenges

Innlandet Health Trust

• 390 000 inhabitants

• 2 counties

• 9 hospitals

• 41 units all in all

• only specialist services

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Innlandet Health Trust

8427 employees

Ann. budget CAD 1 bn

1301 beds

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Strategy in the trust: Core components

• Find and create perceived needs

• Build on existing structures and processes

• Evidence-based knowledge support systems

• Create good examples

Overall strategy• Involvement of leaders

• Clinical councils

• Permeation in strategies

• National and regional support

• Cultivating networks

• Mass media

• Action plans

Leadership and clinical councils

• Weekly leader meetings

• Trust strategies

• Trust board

• Challenges to councils

National and regional support• Employees in SI

extensively involved

• Pilot projects in SI– i.e. procedures

• Influencing the regional authorities– i.e. care pathways

Fostering networks

• Social media

• Radical transparency

• Department + friends

Mass media

Action plan 2010

Teaching EBM

Teaching the clinical staff EBM

• Lectures and courses

• Plan, do, study, act

• Work files

• Building EBM education into the hospital structures

• Champions to/from national conference

Our practice-what we tell ourselves to do

Clinical care pathways• Order from regional

health trust

• Using AGREE tool in development

• Evidence-based implementation

• Initiatives to improve user interface

Best practice – best process – best results

New interface

Role-based filtering

Phase-based filtering

One-click to in-depth information

Evidence-based procedures & guidelines

The challenge:

• 6000 procedures in SI

• 4000 outdated

• Most are local

• User interface sub-optimal

• No transparency of method

Evidence-based procedures & guidelines

The ”CEPI” project

• Common...

• evidence-based...

• procedures...

• on the internet...

Evidence-based procedures & guidelines

Evidence-based procedures:

• support to councils

• AGREE tool

• transparent methodology

• national initiative

Nursing care plans

• 120 finished

• AGREE tool

• better quality

• better documentation

• Learning tool

Handbook of implementation• EPOC and NIRN

• checklists

• tools

• Demand outside of trust

EBM library services

EBM librarianship

Librarians educated in EBM

Literature searches based on 6S model care plans procedure care pathways

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EBM webpage for clinicians

Learning tools Tools for making and

implementing practice Litterature searches The Egg Tests in information

literacy Implementation

handbook

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Access to knowledge sources• Map of Medicine?

• UpToDate

• NEL?

• PPS?

The knowledge egg

• 6S model as the base

• In collaboration with McMaster/HIRU

• Meant for the Norwegian El. library

• 2.0 version ready for launch

Use of UpToDate before and after the Egg

EBM research

EviCare• “Evidence-based

practice in clinical decision support systems”

• A research program in the VerdIKT program of the Norwegian Research Counsil

EviCare

Knowledge and prototypes

Journal in collaboration with the Norwegian Health Library

• Mental health only

• 1200 subscribers

• Short news articles based on feed from McMaster PLUS

• ++