Savings Beyond Price™
Innovative Supply Savings and Quality Solutions That Work
by Strategic Value Analysis® in Healthcare
Did You Know...?
That Value Analysis Was Developed Back In the 1940's After World War II as a Way to Find Lower Cost but Higher Quality Alternative products and methods. This was Due to the Lack of Material Resources At The End of The War.
Savings Beyond Price -Weekly eNewsletter - November 09, 2010
Robert T. Yokl
President & Chief Value Strategist
Best Practice vs. Evidence-Based Practice
Greetings,
At first glance, you might think to yourself that a best practice is evidence-based. Or is it? A recent article by Kathleen D. Sanford, Senior Vice President and Chief Nursing Officer, Catholic Health Initiatives in HFMA Magazine tells another story. Sanford’s definitions of both are as follows:
Best Practice: There may be some research that supports this practice, but it is not yet backed by rigorous research studies. A hospital may determine that a particular best practice has resulted in improved outcomes (e.g., improved patient satisfaction, reduced supply costs) for its patient population.
Evidence-Based Practice: Rigorous research studies, preferably controlled studies, indicate that an evidence-based medical or nursing practice is more effective than other practices in achieving a desired outcome (e.g., reduce incidence of infection, a lower length of stay).
Do you see the difference? Anecdotal or loosely based evidence, even if reported by hundreds of practitioners, doesn’t make a best practice legitimate. Do you remember when it was believed that almost all stomach (or Peptic) ulcers were thought to be caused by stress? Now, we know with certainty, based on rigorous evidence-based research in 1982 by two Australian scientists, that 70% to 90% of Peptic ulcers are cause by bacteria. It’s interesting to note that John Lykowkis, a general practitioner in Greece, believed Peptic ulcers were caused by bacteria in 1958, and then treated his patients with antibiotics (now an evidence-based best practice), but he never did the rigorous evidence-based research to prove it. Unfortunately, he left the rest of his colleagues to figure it out for themselves.
What does this mean to you? When deciding on what should be a best practice for your hospital, always look to evidence-based practices first. For example, Sanford stated in her article that Catholic Health Initiatives (CHI) has rigorously researched bed making at their 74 hospitals and has decided not to change bed linens on a daily basis, except for bedridden patients or when linens become soiled or if a patient requests it. CHI projects they will save $3 million annually by doing so. I know that hundreds of hospitals follow this same bed making policy, but has anyone of them ever rigorously researched it?
The crux of deciding on a best practice for your hospital, system or IDN’s clinical or business operations is this: If your healthcare organization or some other respected organization (e.g., ECRI, JAMA, CMS, etc.) hasn’t rigorously researched, with double-blind studies if feasible, what really works you can’t really call what you are doing a best practice.
It’s just your opinion!
Warmest Regards,
Robert T. Yokl
Chief Value Strategist
Strategic Value Analysis® In Healthcare
Bobpres@strategicva.com
1-800-220-4274Your Partner In Savings Beyond Price™,
P.S. You want check out my blog article “A Simple Lesson we too Often Overlook” at the Journal of Healthcare Contracting on line if you are looking for more savings ideas to add to your arsenal.
P.P.S. You also might want to visit our newly reconstructed blog which has been organized, by our webmaster Glenn Giersdorf, into four categories (e.g. value analysis, utilization, best practices, and supply chain) for ease of use. Another nice feature of our new blog is the “most popular articles” section that shows in real-time what your peers have found of interest.
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