Improving Health Systems’ Access to High-Quality Evidence: AHRQ EPC 2018 Pilot Projects Summary [Internet]

Excerpt

Introduction: Health systems want to use the best evidence available in their decision making, but they have limited time and resources to identify and evaluate evidence from systematic reviews. EPCs initiated a series of pilot projects in order to identify effective approaches to accelerate the uptake and implementation of evidence from systematic reviews.

Methods: EPCs developed, piloted, and evaluated nine products to facilitate dissemination or implementation of information from selected EPC systematic reviews in health systems. They conducted interviews with their health system partners to evaluate potential usability of their product. While the pilot projects were being evaluated, the EPCs met in person and used a nominal group technique to develop recommendations for the EPC Program, based on their lessons learned. After completion of reports and evaluations, the SRC conducted a content analysis of EPC pilot reports and of a semi-structured survey from all EPC projects.

Results: EPC products varied widely, ranging from dissemination products (e.g., short summaries of EPC reports) through interactive data visualization products (e.g., interactive maps) to implementation products (e.g., electronic health tools and decision aids). Most EPCs required additional expertise beyond the typical systematic review team and several needed to synthesize additional literature in order to develop their product. All required additional time to develop the products (range from 20 hours to 2,850 hours), which corresponded to the amount of additional information or expertise needed beyond the typical systematic review team. Dissemination products summarized results from systematic reviews and required on average 57 hours to develop. Interactive data visualizations used technology or software to enable an interactive interface with findings of reports and required on average 152 hours to develop. Implementation products helped health systems implement evidence into practice, and required on average 1,077 hours to develop. All but one health system reported the products would help them use evidence from systematic reviews in practice. Health systems found projects likely to improve dissemination and implementation of evidence reports by tailoring the information to suit health system needs. The only health system that reported the product would not help them implement evidence into practice was not currently facing a decisional dilemma related to the healthcare topic.

Conclusions: Companion products may help health systems use findings from AHRQ evidence reviews. Dissemination products required the least time investment, while implementation products required the most. Alternative presentation formats may allow expert users and stakeholders to interact with evidence synthesis in a more meaningful and useful way. When planning a companion product, authors should work with health systems to understand the needs and decisional dilemmas, so that context-specific information can be gathered during the review and the report can be tailored to fit evidence needs. Companion products can augment reports to improve usefulness, but require additional time and resources. Different formats may be useful for different audiences and tailored content may be more useful than general summaries. Further research is needed to understand which formats are most effective in which contexts.