Integrating evidence-based practice with quality management. (Special Report: Evidence-Based Practices).

Emphasis on use of research to support clinical practice is long-standing. The emergence of the evidence-based practice movement has generated renewed interest and support for utilization of research findings as the basis for practice and treatment approaches. Although several definitions of evidence-based practice exist, it is generally accepted that it consists of treatment approaches, interventions and services that are supported by research as being effective in achieving desired clinical outcomes.

Despite strong research supporting use of evidence-based practice in behavioral health treatment, movement from research to practice is difficult and problematic. Two main obstacles are organizational and professional issues. This article will explore evidence-based practice, implementation, and the value of integrating evidence-based practice into quality management. The integration of evidence-based practice into quality management approaches will assist with the successful implementation of evidence-based practices.

Implementation of evidence-based approaches

Organizations are pursuing implementation of evidence-based practices in order to standardize service delivery and improve patient care. Evidence-based practice is well-supported in a number of treatment domains and has resulted in publishing of related practice guidelines. One area that has received attention is supported employment. Critical components of supported employment have been identified as predictive of better employment opportunities for individuals with severe mental illness. Another area of attention has been pharmacological and psychosocial treatment of depression, dementia and alcohol abuse in geriatric populations.

Evidence-based treatment is supported with assertive community treatment interventions and use of psychoeducation with families of individuals with psychiatric disabilities. Other studies document effective use of evidence-based outcome research as part of routine clinical practice, while others demonstrate lack of research support for certain types of treatment interventions such as peer-based, group-based interventions.

Review of evidence-based research also reveals some areas of omission or minimal attention. While most evidence-based research has focused on target patient populations, there is little research on patient-specific factors that affect treatment. For example, such factors as diagnosis, intensity of symptoms, motivation, recovery environment and previous treatment history have been studied extensively as predictors of need for treatment and appropriate treatment settings but have not been empirically associated with …