Evidence-based decision-making (EBDM) is not new to healthcare; stakeholders are well aware of the promise it holds. But while there are excellent examples of successful EBDM, its influence on policy at the system level is far from realized. Why, despite volumes of literature on barriers to EBDM – and solutions to overcome them – do we struggle? How can we embrace EBDM to help sustain and strengthen our Canadian and provincial healthcare systems?
One promising initiative is Canada’s Strategy for Patient-Oriented Research (SPOR), a $650M+ coalition of federal, provincial and territorial partners led by Canadian Institutes of Health Research, dedicated to the integration of research into care.
Under SPOR, SUPPORT Units (Support for People and Patient-Oriented Research and Trials) have been established across Canada to strengthen patient-oriented research. The Units’ resources and services are critical supports for EBDM. But the real key to SPOR and the Units’ success is in looking beyond these practical offerings to the social and structural elements that prevent or enable EBDM. SUPPORT Units have committed to a new and equal partnership among patients, researchers, practitioners, and policy-makers to ensure these elements are addressed.
Success means establishing shared goals and measurements and supporting people to play new roles. But it also means tackling issues of power, politics, conflicting incentives and different rules (real or perceived) by which various stakeholders operate. Such issues are largely ignored: they are either too difficult to deal with, or they are so entrenched, we don’t recognize them as problems. SPOR presents an opportunity to resolve them.
This provocative panel represents three SUPPORT Units: Ontario, Alberta and BC. Three case studies on EDBM will be presented, each by a Unit lead and a partner (policy-maker, researcher, patient). Cases will address practical elements of EBDM (skills, training, access to evidence) – but also the social and structural. What rules and incentives must change for EBDM to work? How can we move from a culture of competition – which is research today – to one of collaboration, and what are the trade-offs? How can patients have equal power as decision makers? How do we measure progress, with the current demand for quick fixes and quantitative results? How can our definition of science expand to include the disciplines of change management, organizational culture and system change?
We end with questions for the audience, and invite feedback on what it really takes to embrace EBDM in healthcare.
