The Ottawa Hospital: Recommending an Evidence-Based Practice Change

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Introduction

The Ottawa Hospital is one of the most admired in Canada. In 2017, the hospital had an unwelcoming and negative culture (Forster et al., 2019). The leaders solved the problem, which indicates the organization’s readiness for changes.

Opportunity for Change: Circumstances

Though clients are provided with special patient decision aids, this system is not well established, and not all patients take these tools seriously. There is a necessity to improve the system and encourage patients to use it.

Opportunity for Change: Scope of the Issue

Improving patient decision aids will allow diabetics with COVID-19 to adhere to the treatment plan, avoid risk factors, and lead a healthy lifestyle.

Opportunity for Change: Stakeholders Involved

The stakeholders involved in the practice change process are:

patients;
general public;
clinicians;
decision aid developers;
researchers.

Opportunity for Change: General Risks

unreadiness of management and staff to accept changes;
patients may experience difficulty accessing and evaluating clinical information;
failure to address barriers to implementation (Schroy et al., 2014).

Proposing an Evidence-Based Idea for a Change in Practice

select the best decision aids and keep them reputable and updated (ACP Decisions Foundation, 2020);
designate a multidisciplinary professional team;
encourage clinicians and patients to use the aids.

Plan for Knowledge: Transfer

Analyzing literature and collecting evidence.
Gathering key messages in a presentation.
Providing it to the Ottawa Hospital management.
Recommending it to assess the risks and outcomes and follow the proposed plan.

Disseminating the Results

Two dissemination channels are selected for this project:

social media networks will allow building a reputation online;
conferences will make it possible to attract specialists and stakeholders.

Desirable Measurable

The measurable outcomes include an increased number of patients using the decision aids (Hoffman et al., 2014). Patients’ better satisfaction and more successful treatments and reduced mortality of diabetics with COVID-19.

Lessons Learned: Summary of the Critical Appraisal

The critical appraisal of the peer-reviewed articles is devoted to identifying the best practices. They are not special and a hundred percent effective treatments (Abdi et al., 2020), but they may help diabetics with COVID-19 to feel better and recover sooner.

Some interventions include glycemic and blood glucose control, self-monitoring, in-home visits, remote patient monitoring, higher acuity office visits, and use of social media (Abdi et al., 2020), leading a healthy lifestyle (Abdi et al., 2020, Singh et al., 2020).

References

Abdi, A., Jalilian, M., Sarbarzeh, P. A., & Vlaisavljevic, Z. (2020). Diabetes and COVID-19: A systematic review on the current evidences. Diabetes Research and Clinical Practice, 166. Web.

ACP Decisions Foundation. (2020). How to integrate patient decision aids into clinical practice. Web.

Forster, A. J., Hamilton, S., Hayes, T., & Légaré, R. (2019). Creating a Just Culture: The Ottawa Hospital’s experience. Healthcare Management Forum, 32(5), 266–271. Web.

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296.

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