Thursday, August 28, 2008

Evidence Based Management

I have to thank Addicted to Medblogs lack of knowledge for this post. She asked KevinMD what evidence based medicine means? For those of you who haven't heard the term take a quick trip to AMB for a quick read then come back. In short, it is when you apply scientific method to your clinical practice. The better the science, the more credence you give the work and the bigger its' impact on your practice.

Administrators can use the same technique because clinics are faced with the same dilemmas. I continually read opinions about the best booking practice. "Have all patients arrive at once", "have two arrive every 15min", etc.... or a friend that bases clinic decisions on gut instinct rather than reality. Few clinics use science to examine the impact of their decisions.

The first step is to start recording the changes you make. I don't do anything specific, just a small Word document where I record the date and the change. Sometimes it's meaningless (because it had no effect) and other times you can only see the change in retrospect (example).

In an ideal world, a clinic sets up an experiment with an effective measure then tries something new. We tried it with a new phone screening technique (example). Even better evidence would be to try the new technique at the same time as the old technique where the measurements are not known to those involved in the experiment. In scientific terms; a blinded trial.

It's never to late to start for administrators. When a clinic process is going to be changed ask yourself;

Have I written down what is changing?
How will the change be measured?
What change do I expect?
When will I reassess the process?

Before you know it, you will have a database full of process change and effectiveness based on evidence based management.

No comments: