The future of evidence-based health care and worldviews: A worldwide vision and call for action to improve healthcare quality, reliability, and population health

摘要

Although findings from studies have indicated the multiple benefits of delivering evidence-based practice (EBP), including a higher quality of care, improved reliability (i.e., safety), enhanced patient outcomes, and reduced healthcare costs, it is still not consistently implemented by clinicians in healthcare settings across the globe. Leaders and healthcare systems continue to struggle with how best to create cultures and ecosystems (i.e., environments) that enhance and sustain EBP. Further, although progress has been made over the years, the same barriers to EBP identified decades ago (e.g., time, lack of knowledge and skills, peer resistance, lack of access to resources, and EBP mentors) continue to exist in healthcare systems. Most recently, in a survey conducted with a random sample of 1,000 nurses from across the United States, new findings indicate that resistance from leaders and managers along with environments steeped in tradition were top barriers to the provision of evidence-based care (Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). In order for EBP to be in the DNA of all nursing and other healthcare professionals, radical transformations in healthcare systems and educational programs must take place. Further, clinicians, educators, researchers, and administrators must have timely access to outstanding resources that can be used in real world settings, which will then assist them in providing and promoting the best evidence-based care as well as sustaining EBP cultures and environments in their healthcare institutions.