Sustainability in Health care by Allocating Resources Effectively (SHARE) 7: supporting staff in evidence-based decision-making, implementation and evaluation in a local healthcare setting

Claire Harris,Kelly Allen,Anthony Gust,Cara Waller,Tim Dyer,Dina Farjou,Marie Garrubba,Angela Melder,Catherine Voutier,Vanessa Brooke

doi:10.1186/s12913-017-2388-8

Abstract

BackgroundThis is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately.MethodsLiterature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes.ResultsSurveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed.ConclusionHealth service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research evidence and local findings. Local factors, some unanticipated and some unavoidable, were the main barriers to successful implementation. All three proposed support services hold promise as facilitators of EBP in the local healthcare setting. The findings from this study will inform further exploration.

Highlights

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting
This paper reports on the Data Service, Capacity Building Service and Project Support Service; the Evidence Service is reported in Paper 8 of this series [25]
Respondents included representatives of organisation-wide decision-making bodies, usually committee chairs; individuals with responsibility for resource allocation decisions as part of their role, mainly department or unit heads; members of project teams who had undertaken disinvestment activities; pharmacists and members of medication-focused committees; and staff members enrolling in Evidence Based Practice (EBP) training courses or signing up to participate in the Evidence Service

Summary

Introduction

This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. The ‘Sustainability in Health care by Allocating Resources Effectively’ (SHARE) Program was established to investigate an organisation-wide, systematic, integrated, evidence-based approach to disinvestment in the context of resource allocation decisions. The SHARE Program was undertaken by the Centre for Clinical Effectiveness (CCE), an in-house resource to facilitate Evidence Based Practice (EBP).

Methods

Results

Conclusion