Evidence-Based Practice: approaches to measuring the impact of therapy interventions

Abstract

This lecture will open with a recap of the international drivers for clinical excellence through Evidence-Based Practice (EBP). We recognise that there are strategic and political imperatives for quality assurance of services in health, education and social care. Additionally, there are professional and clinical drivers for us to demonstrate ‘best practice’: we are all accountable to demonstrate that we are keeping ourselves updated with the evidence for effectiveness in our own field of work. However, the traditional definition of EBP belies a range of inherent challenges for practitioners. Primarily, there is the assumption that there is a robust and comprehensive evidence base to draw upon. We certainly need to be aware of the relevant current published research evidence and how to achieve a realistic approach to embedding this within our routine practice; but many research studies are limited to evaluation of discrete and direct therapy interventions. This does not reflect the reality of the complexity of cases that we manage, working within multi-disciplinary teams and services. So we need to challenge the definitions of what constitutes ‘evidence’ and to consider what can be quality markers of additional evidence sources. In particular, we need to have tools and approaches for measuring the outcomes and impact of our therapy interventions which appropriately reflect the contextual factors that influence the outcomes for the individuals we work with. This lecture will consider the differences in using outcome measures in research, in service evaluations, and in case management for individual clients. It will include the respective contribution of case-based research designs, survey, clinical audit, Patient-Reported Outcome Measures (PROMs) and stakeholder consultations.