Evidence Informed Decision Making: a collection of guidelines and resources prepared by the CM Health Library
and CM Health Research and Evaluation teams.
The steps to identify appropriate, contextually relevant evidence to inform decision-making are:
1. Define the research question – for example, what is the most effective intervention for smoking cessation? You will need to know the expected outcome, risks and resource requirements for your prospective intervention.
When creating a project come with a problem, not a solution!. The evidence may change the proposed solution. Do NOT “cherry pick” evidence to support a predetermined or fixed solution to back up a point of view without considering the full body of evidence.
2. Search for the evidence. The library can help you with this step
Use the online form to request the library staff to complete a literature search:
or search yourself through the Library Discovery portal, accessible through Paanui http://cmdhb.ovidds.com.cmdhb.idm.oclc.org/portal
The CM Health Library has an access point to good quality evidence sources on the right hand side of the Discovery Portal under ‘Evidence-based Practice’ http://cmdhb.ovidds.com.cmdhb.idm.oclc.org/portal
Library Resources as follows:
Evidence based practice
The Cochrane Review
Database of Abstracts of Reviews of Effects
PDQ-Evidence for Informed Health Policy Making
Evidence search (NICE)
Nursing+ (pre-appraised evidence)
Health Evidence [public health]
Health Systems Evidence
JBI Database of Systematic Reviews and Implementation Reports
Peel Research Review collection
Guide to Community Preventive Services (The Community Guide) collection
NIHR Themed Reviews
AHRQ Evidence Reviews
3. Appraise the evidence. This means look at the quality of the evidence. Typically, good quality evidence comes from guidelines and reputable systematic reviews and repositories, for example from the Cochrane Library.
It is critical to understand what constitutes good evidence of effectiveness and to critically evaluate all evidence. Priority must be given to identification of meta-analysis and evidence synthesis from health sector recognised sources coupled with systematic reviews and randomised controlled trials. If evidence is from alternative sources such as single studies or case studies it is critical that this evidence is accompanied by a robust and transparent evaluation of outcomes upon which to base its effectiveness. It would be inherently dangerous to rely upon a single paper, case study or trial.
Hierarchy of evidence
Where a priority outcome of an intervention is cost savings then priority should be given to identification of evidence that details economic evaluations of outcomes.
Three broad issues need to be considered when appraising an economic evaluation:
- Is the economic evaluation valid?
- How were costs and consequences assessed and compared?
- Will the results help in purchasing services for local people?
4. Synthesize the evidence. This means gathering and understanding the meaning from the evidence. If you need support the Research & Evaluation office can help.
Ko Awatea’s Research and Evaluation team have expertise in considering evaluations and critically appraising the validity of evidence. They also may be able to assist in creating thematic synthesis of evidence to inform project decisions.
Contact Dom Madell for assistance.
5. Adapt the evidence to your local context. Will implementing this approach be feasible, appropriate and safe?
6. Include the lit review documentation as an appendix to all project proposals including who completed the lit review, the date, databases and sources searched, search terms used and links to all primary sources of evidence. It is important that the process is robust , transparent and rigorous and the culture of ‘”cherry picking” and of selectively omitting relevant resources that do not support a particular proposed initiative be actively discouraged as not acceptable practice at Counties Manukau Health.
7. Disseminate and share your learnings and project outputs
Selected resources to support Evidence Informed Decision Making
(i) National Collaborating Centre for Methods and Tools (NCCMT). The NCCMT facilitates and supports the development of knowledge and capacity to use the best available evidence in practice among public health professionals.
(ii) Canadian Institutes of Health Research. Introduction to Evidence-Informed Decision Making (online learning module)
(vi) BMC Health Research and Policy Systems. What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review
(ix) Guidance [UK]. The Prioritisation Framework: aking the Most of Your Budget. A flexible tool to making transparent, evidence-based spending decisions across public health programmes.
(xv) Knowledge Management clearinghouse from NHS Scotland: summarises the existing evidence on knowledge translation competencies for use in capacity building efforts and to inform policy and research.
An evidence reality check: How individual managers and organisations make sense of and use research information when making decisions: lessons learned and a way forward
(ii) What evidence do individual managers use. From surveys, interviews, focus groups and observational research of different kinds, we have learned that managers rarely seek formal, research-based information from academic journals or other sources.
(iii) How do organisations use evidence? We do not know enough about the reasons why some organisations are better than others at using evidence to make decisions. Attention has shifted in recent years from a focus on how individuals seek and use information, to how organisations draw on evidence and what support they need to do this well.
Selected collections of evidence to inform Counties Manukau Health projects
"Every hour counts" / "Every dollar counts": Evidence and resources to assist with the identification and evaluation of opportunities across CM Health's services to improve efficiencies and effectiveness of services
E-integrate evidence reviews prepared by CM Health Research and Evaluation team