Before I jump into why active evidence-based practice is so important, let me first clarify what I mean when I use that phrase: active evidence-based practice is all the evidence-based good stuff you’re already familiar with (i.e., learning from others through research studies, webinars, or continuing education courses) with the addition of putting into practice everything you’ve learned and then measuring the results. While there’s nothing wrong with the standard, passive type of evidence-based practice—it’s a great place to start—it’s simply not enough on it’s own. After all, evidence-based practice is rooted in the scientific method—and the scientific method requires a willingness to continually test and retest hypotheses (whether those are yours or someone else’s). In other words, in order to truly embrace evidence-based practice, you also must embrace the never-ending process of learning, applying, testing, and improving.
Still not convinced there’s a reason to go beyond passive evidence-based practice? Think of it this way: if you blindly adopt a new treatment method or approach—even one that’s been well-vetted—without measuring the impact it has on your practice and your patients, then how do you know it’s actually effective in the ways you want it to be? You don’t—at least not in a way you could definitively prove (i.e., for which you could supply evidence). And that means your practice as a therapist isn’t truly evidence-based.
So, how do you obtain that evidence? By tracking your outcomes data. Now, I spend a lot of time writing (and speaking) about the importance of outcomes tracking—specifically, in the context of payment reform. That’s because therapists must have objective data in order to prove their value and thus, get paid what they deserve. But, that’s not all: therapists also must have objective data to achieve active evidence-based practice. Because no matter what the research says, the only real way to know whether the plan of care you prescribe a particular patient is the most effective one available is to track the results (via patient satisfaction surveys and outcome measurement tools) in a consistent and standardised manner. And if you’re using the best integrated outcome measurement tools, you’ll also be able to control for complicating factors, such as age, weight, litigation, diabetes, cancer, and heart disease. That way, you can make risk-adjusted comparisons between patients and diagnoses.
To make your data meaningful, though, you have to do more than just track it; you also have to process and analyse it in a way that you can use to inform your clinical decisions. And because you probably don’t have the time—or the desire—to plug all of your outcomes data into an Excel spreadsheet and run the calculations necessary to make sense of it yourself, you’re probably going to want to find outcomes tracking software that does all the analysis and data visualisation work for you. It’s even better if you can find a solution that’s already integrated with your EMR (that way, you don’t have to enter your data twice) and allows you to filter your reports by diagnosis, therapist, clinic location, or any other variable you can think of.
With this level of detailed data at your fingertips, you’ll be able to not only hold yourself—and your team—accountable for care quality, but also empower your entire practice to make even more informed care decisions in the future. Now that is active evidence-based care. And the benefits go beyond your individual practice; wide-scale adoption of an active evidence-based practice philosophy could help effectively standardise the quality of care across the physical therapy profession. That’s because it encourages providers to use a standard, universally accepted set of tools as well as push for the development of objective quality guidelines. And that, in turn, will go a long way toward improving the PT brand—in the eyes of consumers as well as other members of the healthcare community. This is especially important, because as it stands now, there’s so much variation in care quality from clinic to clinic that neither patients nor other providers know what to expect from any given therapy practitioner. And that uncertainty can lead to a general wariness when it comes to seeking—or prescribing—therapy.
I know this isn’t an easy topic to bring up—the fact that some of our professional colleagues aren’t as devoted to providing the best possible care as we’d like them to be. But, it’s true, and there’s no sense in beating around the bush any longer. It’s dragging our entire profession down—and we’ve let it go on for too long. It’s simply not fair to the smart, devoted, and caring therapists who have dedicated their careers to providing exceptional care—or to the patients who will never benefit from their services. The good news, though, is that by embracing active evidence-based care—and outcomes tracking—we can decide for ourselves what constitutes great care. Then, we can ensure that everyone practicing physical therapy upholds the standards we’ve set.
I, for one, think it’s time to set the bar. If you’d like to learn more about active evidence-based care and other strategies for disrupting the status quo in ways that will benefit our profession for decades to come, check out this free webinar I hosted.