Evidence synthesis activities of a hospital evidence-based practice center and impact on hospital decision making.
BACKGROUND
Hospital evidence-based practice centers (EPCs) synthesize and disseminate evidence locally, but their impact on institutional decision making is unclear.


OBJECTIVE
To assess the evidence synthesis activities and impact of a hospital EPC serving a large academic healthcare system.


METHODS
Descriptive analysis of the EPC's database of rapid systematic reviews since EPC inception (July 2006-June 2014), and survey of report requestors from the EPC's last 4 fiscal years.


METHODS
Descriptive analyses examined requestor and report characteristics; questionnaire examined report usability, impact, and requestor satisfaction (higher scores on 5-point Likert scales reflected greater agreement).


RESULTS
The EPC completed 249 evidence reviews since inception. The most common requestors were clinical departments (29%, n = 72), chief medical officers (19%, n = 47), and purchasing committees (14%, n = 35). The most common technologies reviewed were drugs (24%, n = 60), devices (19%, n = 48), and care processes (12%, n = 31). Mean report completion time was 70 days. Thirty reports (12%) informed computerized decision support interventions. More than half of reports (56%, n = 139) were completed in the last 4 fiscal years for 65 requestors. Of the 64 eligible participants, 46 responded (72%). Requestors were satisfied with the report (mean = 4.4), and agreed it was delivered promptly (mean = 4.4), answered the questions posed (mean = 4.3), and informed their final decision (mean = 4.1).


CONCLUSIONS
This is the first examination of evidence synthesis activities by a hospital EPC in the United States. Our findings suggest hospital EPCs can efficiently synthesize and disseminate evidence addressing a range of clinical topics for diverse stakeholders, and can influence local decision making.
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Kishore L
KL
Jayakumar
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Julia A
JA
Lavenberg
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Matthew D
MD
Mitchell
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.|Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
Jalpa A
JA
Doshi
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Brian
B
Leas
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.|Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
David R
DR
Goldmann
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.|Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Kendal
K
Williams
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.|Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Patrick J
PJ
Brennan
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.|Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.|Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.|Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.|Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania.
Craig A
CA
Umscheid
D003659:Decision Making, Organizational; D055317:Evidence-Based Practice / Q000379:methods*; D006739:Hospital Administration; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D058028:Research Report; D011795:Surveys and Questionnaires; D014481:United States