Evidence Based Practice

Assignment #2
Submitted by: Ambreen Bibi
Sap id: 3384
Submitted to: Dr. Fizzah Mahnoor
DPT 7th A semester
EVIDENCE-BASED PHYSIOTHERAPY IN THE CONTEXT OF
CONTINUOUS QUALITY IMPROVEMENT
Making evidence-based physiotherapy happen should have benefits for
patients, as they receive more effective care, which should in turn lead to
better health outcomes. Evidence-based physiotherapy is only one
dimension of quality improvement and should not be implemented in a
way that is isolated from an overall organizational quality improvement
system. Whether the ‘organizational system’ is a sole practitioner
practice, a 1000-bed hospital, or a community service in a remote
setting, there will always be a range of processes or pathways of care for
patients. For example, a pathway could extend from the point of entry
of a patient into the health care system, to the identification of needs,
referral, tests (single or multiple), treatment by a single or team of
practitioners, social support, identification of a longer-term plan or
strategy for ongoing care or prevention of recurrence.
The pathway crosses departments and organizations horizontally – it is
not hierarchical in nature. The physiotherapist’s application of evidence-
based physiotherapy needs to be seen in the context of, and must be
sensitive to, the whole care pathway.
Good organizations strive to continually improve their processes of care
(continuous quality improvement) and physiotherapists should engage in
this process. As people actually working in a particular setting, they
often know which services function best and what the problems with
services are. They are therefore well placed to make improvements.
A progressive organization will empower staff to identify the potential
for improvement and instigate change. The culture of an organization is
all-important. A good organization will have a culture of striving for
improvement and places high importance on staff learning.
Continual improvement requires leaders who can support and nurture
individuals and who believe that individuals want to do better, to learn
and to develop. Donald Berwick, a pioneer of continuous quality
improvement, once famously said ‘Every process is perfectly designed
to achieve exactly the results it delivers,’ which suggests that if a process
is not working it ought to be changed.
The theme of continuous improvement can also be applied at an
individual practitioner level. Part of the responsibility attached to being
an autonomous practitioner is a responsibility for keeping up to date and
striving for improvement through learning. Physiotherapists can set up
their own continuous improvement cycles through the measurement of
their practice (audit, outcomes evaluation) and by reflective practice and
peer review.