Evidence-based practice in primary healthcare from the managerial point of view – a national survey

Abstract

Background The vast availability of and demand for evidence in modern primary healthcare force clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary healthcare managers play a key role in implementing these governing documents. Thus, the aim of this article is to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary healthcare managers. Methods The study is based on a national survey of primary healthcare managers, consisting of 186 respondents, recruited nationally from Sweden. The data was analysed using empirically constructed concepts and validated using factor analysis. A chi-square test was utilized to determine the statistical significance of comparisons. Associations between variables were calculated using Spearman’s correlation coefficients. All tests were two-sided, and the significance level was set to 0.05. Results A majority (97 %) of managers stated that guidelines and policy documents impacted primary healthcare; 84 % of managers observed a direct effect on daily practices. Most of the managers (70 %) stated that some adaptation was needed when new evidence was introduced. The managers emphasized the importance of keeping themselves updated and open to new information about work routines (96 %). Conclusions The study illustrates a nearly unanimous response about the influence of clinical evidence on daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date is viewed as a direct result of this effect on daily practice. An information-dense organization such as a primary healthcare organization would have much to gain from increased cooperation with regional information resources such as clinical libraries.

A Feeling of Ambiguity: A Qualitative Content Analysis of Managers’ Experiences of Evidence-Based Practice in Swedish Primary Care

“…6 While the required information skillset must be acquired by each individual HP, the facilitation of EBP, in the form of ensuring the availability of support, resources, and a research culture, is the responsibility of the local management. [10][11][12][13][14][15] Managers are often recruited from the HP-staff within primary care with their own individual preunderstanding of EBP.…”

“…17 In their study of Swedish managers experiences of and attitudes toward working with EBP, Abelsson et al reported that knowledge of evidence and its impact in the local PHC is generally good. 12 However, the time devoted to gathering evidence and keeping up-to-date in their field varied. 12 Lack of time and knowledge about information resources has been identified as potential barriers to the implementation of EBP.…”

“…12 However, the time devoted to gathering evidence and keeping up-to-date in their field varied. 12 Lack of time and knowledge about information resources has been identified as potential barriers to the implementation of EBP. 5,15 One of the prerequisites for EBP is HPs' knowledge and ability to collect and implement evidence.…”

Knowledge, Attitude, and Practice towards Evidence-Based Medicine among Northern Saudi Primary Care Physicians: A Cross-Sectional Study

“…The barriers to EBM practice can be related to personal, social, and work-related aspects. Overcoming the obstacles to EBM practice is critical for successfully implementing evidence-based practice in primary health care [ 33 , 34 ]. The findings of the present study suggest that age is one of the strongest predictors of evidence-based practice.…”

The dilemma of the split between theory and reality as experienced by primary health care professionals: a mixed methods study of evidence- based practice in a primary care context

“…Where critical thinking and analysis of complex information are of paramount importance (2). These skills are essential in Evidence-Based Practice (EBP) as well (3)(4)(5). EBP is a process of merging the patient´s values and preferences with clinical expertise and the latest evidence to evaluate and give the best possible care to the patient (6,7).…”