1. Policy Change Department of Veterans Affairs
Health Services Research & Development Service
Lynn McQueen, DrPH, MS, RN
Evidence-Based Practice:
Policy Change
June, 2002

2. Overview Policy and evidence-based practice Implications and context
What are we doing?
Similarities in cross-national approaches & methods
Differences in cross-national approaches & methods
Is it working?
Overall gaps and shared priorities
Towards an international agenda
Action steps & Challenge for this meeting

3. Evidence-Base Practice Within A Policy Context
The implications of using a policy perspective
Historical influences
Current trends
Key definitions and concepts
Policy implementation across systems
Evaluation and impact measurement
Feedback, use, evolution
Shared priorities, goals, and resources

4. What are we doing? Is it working?
How do we collectively learn from each other so that we can:
Advance individually?
Evolve the collective state of science?
Tackle the tough issues at increasingly complex levels?
Know if it’s working?
Build momentum?

5. Similarities Goals Local National International
Approaches, Methods, & Measures
Who is doing what?
How do we find out?
Where are the intersections?
How do we fill gaps together?
Roles
Mechanisms

6. Differences Goals Historical Social & political Economics Professional
Overall incentives
Approaches, Methods, & Measures
Resources
Output
Use
Interpretation
Feedback
Overall incentives

7. A Powerful Intersection !
Shared Challenges
Shared Priorities

8. Towards An International Agenda
Agreement on Basics
Action Steps
Dealing With Complexity & Differences
Starting Points
Challenges For This Meeting

9. Agreeing On Basics? Output Feedback mechanisms Communication
Definitions
Concepts
Models
Approaches
Methods
Measures
Output
Feedback mechanisms
Communication

10. Agreeing On Goals? Adding To Translation Science
Findings of common interests
E.g. the effectiveness of reminders
Processes of common interest
E.g. reminder effectiveness is influenced by how many are implemented

11. “Evidence-Based Quality Improvement” (EBQI) is systematized so that...
Agreeing on ideas and concepts?
“Evidence-Based Quality Improvement” (EBQI) is systematized so that...
Providing the right care at the right time to the right patient becomes routine

12. Agreeing on Output? What Type? What Format?
Diabetes: Efforts to increase provider awareness of diabetes treatment priorities were associated with changes in medical care that will substantially reduce both cardiovascular events and deaths. Over the next five years, this will result in about 4,000 fewer heart attacks and strokes and will prevent about 3,000 deaths.

13. Agreeing On Evolution Of Evidence-Based Tools?
Development, use, improvement of decision aids
Feed back to decision-makers in useful formats, when needed
Use what we have now but pushing the boundaries
Ever-increasing interpretation and ability to deal with complexity & uncertainty

14. Agreeing On An International Model That Supports Integration
Expand overall policy advancement through integration of the shared needs at the intersection of:
Evidence-based quality improvement (EBQI)
Research

15. International Policy Change
Research
Shared Goals, Resources, Output
IMPACT
Findings, Impact
Feedback/ Improved Care
Clinical QI

16. Action Through Relationships & Communication Around An International Need
Demonstrating What Is Possible Through…
Actively engaging key target audiences
Finding common incentives
Building formal & informal networks
Developing an international action plan

17. Summary: Policy Improvement In Evidence-Based Health
Policy and evidence-based practice Within Context
More similarities than differences
Similarities in cross-national approaches & methods
Differences in cross-national approaches & methods
Much to learn from each other
Overall gaps and shared priorities
Agreement needed on key issues
Develop a model and action plan together during this meeting