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Practice in the Field of Healthcare: Literature Review
Introduction
The topic that will be focused on in the literature review will be the way evidence supports practice in the field of health care. The review will involve determining how evidence supports health care practices as well as the problems that exist with this approach. The research will also determine if evidence supports practice in health care has lead to reforms in the health care industry. Evidence supported practices in the health care industry has taken the form of evidence based medicine, evidence based health care or evidence based practice. The use of medical research and evidence in health care has continued to grow over the years as more clinicians and doctors turn to the use of research to treat and diagnose patients suffering from various ailments (Drake et al, 2001).
Evidence that is supported by practice in health care involves using the best available health care evidence that has been derived from scientific and clinical research to make a clinical decision with regards to a patients health. It involves evaluating the various bodies of medical research to determine what are the most suitable treatments for certain diseases. Health care that is evidence based seeks to assess the strength of evidence that exists in the various risks that come with health care treatments and disease diagnosis. The aspect of evidence-based healthcare depends on the quality and value-of-life judgment decisions that are made by medical professionals in the course of their work (Drake et al, 2001).
Analysis of the Topic
According to Timmermans and Mauck (2005) evidence that is supported by the practice of health care aims to address the persistent problem that exist within clinical settings where there are variations in the type of tools used to address health care problems. Evidence in health care is usually supported by strong scientific foundations and it is of two types: evidence-based guidelines and evidence-base decision making.
Facts-based principle involves the practice of facts-based medication at either the clerical or institutional rank of the health care facility. This type of evidence-supported practice involves the formulation of guidelines, policy and regulations that will be used in the provision of health care. Evidence-based decision making is practiced by individual health care providers such as doctors, physicians, nurses, pharmacists and other health care providers. Evidence in health care incorporates the use of medical literature, randomized controlled trials and risk analysis to make conscientious decisions in clinical situations (Timmermans & Mauck, 2005).
Evidence that is supported by practice incorporates the use of published research studies that have been systematically reviewed to evaluate the effectiveness of particular treatments in dealing with certain ailments. One such body that is involved in the systematic review of evidence based research literature is the Cochrane Collaboration which provides various authors and researchers with a forum to present their detailed literature searches and evaluations of medical evidence. The Cochrane Collaboration analyzes all the best evidence on a variety of topics after which evidential information is assessed based on whether it is likely to be beneficial to the medical field or harmful (El Dib et al, 2007).
According to a review of evidence-supported practice done by El Dib et al (2007) on the Cochrane Collaboration, 44% of the reviews demonstrated that evidence into practice supported healthcare was likely to be beneficial in the healthcare industry while 7% of the reviews found evidence supported practice to be harmful in the clinical application of the research. 49% of the reviews found that evidence when supported by practice in healthcare did not benefit or harm them during their clinical applications.
El Dib et al (2007) noted in their study that all health care evidence that was practical in nature was used in the clinical decision making process of how to treat patients that suffered from either acute or chronic pathologies through the use of treatments that were supported by scientific literature and also in the evaluation of medical research information that would promote the treatment of illnesses (El Dib et al, 2007).
While there has been a lot of support for evidence based medicine and health care practices that are supported by medical evidence, there has been a lot of criticism on this topic as most medical practitioners argue that evidence based practices in health care are more than likely to lead to theoretical based medicine. The major problems of evidence supported health care are that physicians and doctors are the sole decision makers when it comes to the health care of individual patients.
This makes it difficult to use medical research as a basis for patient treatment and diagnosis. Another criticism of evidence based research in health care practices is the health care providers ability to appraise and evaluate medical research when treating patients. Getting the proper information to treat or diagnose patients requires having research evaluation skills as well as accessibility to various journals. If the health care provider lacks the appropriate skills to conduct research, then the use of evidence in medical practices becomes difficult (Salmond, 2007).
Review of Literature
The interest in health care that is supported by medicine has continued to grow in both the public and private health care systems in the world. However, Bernstein et al (2010) concede that evidence supported practices in health care help individual patients and health providers to make informed decisions on the treatment alternatives that are available in treating various illnesses. With regards to health care reforms, federal health reform systems especially those in the US have emphasized the importance of developing evidence based practices to improve the quality of health care that American citizens are receiving in the various health facilities within the country.
Health care reforms have begun to focus on the use of evidence based practices where findings from effective research have been used to compare the alternative treatments so as to ascertain which is the best. Bernstein et al (2010) note that moving evidence into practice involves the development of new information systems that will be used to report the research findings to the relevant health care providers.
Health experts in various medical fields have contended that the development of evidence supported practices in health care are essential to improving the quality and efficiency of health care systems around the world. According to Bernstein et al (2010), the Patient Protection and Affordable Care Act enacted by the US Congress in March 2010 embraces the use of evidence supported practices in reforming the health care industry in the United States. The Affordable Care Act has provided the opportunity for evidence based health care facilities to form non for profit patient-centered research institutes that will be used to research on various medical ailments.
These research based centers under the ACA have also been enacted to foster research efforts that will compare the effectiveness of health treatments with health strategies. This has ensured that there is the implementation and evaluation of evidence-based practices in the provision of health care services. Evidence supported practices have also been used by the American Recovery and Reinvestment Act (ARRA) of 2009 to expand all the major facilities in the US that are used for evidence based research in the medical field. The ARRA has been used in conjunction with other federal agencies such as the Veterans Health Administration (VHA) and the National Institute of Health (NIH) to develop and disseminate effective research that will be used to support evidence based health care (Bernstein et al, 2010).
The Agency for Healthcare Research and Quality (AHRQ) under the ARRA established an effective health care program that was focused on providing medical interventions for people suffering from serious chronic ailments. This center incorporated the use of evidence based research to conduct a comparative analysis of the various types of treatments that can be used to treat chronic diseases and ailments. Such institutions demonstrate that evidence supported practices in health care have played a major role in the health care reforms of the health care system in various countries around the world (Bernstein et al, 2010).
Conclusion
The purpose of this study has been to determine how evidence supports practice in the health care industry as well as the various problems that exist in evidence supported health care. The study has also dealt whether evidence supported health care practices have led to any health care reforms in the health industry. The findings have revealed that several institutions with particular focus in the US have established institutions and organizations that have been used to improve the health care of US citizens through the use of evidence supported medical practices.
References
Bernstein, J., Chollet, D., & Peterson, S., (2010). Basing health care on empirical evidence. Mathematica Policy Research, 3: 1-4.
Drake, R.E., Goldman, H.H., Leff, S., Lehman, A.F., Dixon, L., & Mueser, K.T., (2001). Implementing evidence-based practices in routine mental health settings. Psychiatric Services, 52: 179-182.
El Dib, R.P., Atallah, A.N., & Andriolo, R.B., (2007). Mapping the Cochrane evidence for decision making in healthcare. Journal of Evaluating Clinical Practice, 13(4): 689-692.
Salmond, S. W., (2007). Advancing evidence-based practice: a primer. Orthopedic Nursing, 26(2): 114-123.
Timmermans, S., & Mauck, A., (2005). The promises and pitfalls of evidence-based medicine. Health Affairs, 24(1): 18-28.
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