Campaigning for safety

There are four challenges to practicing evidence-based medicine: obtaining the evidence; evaluating the evidence; promulgating the evidence; and persuading practitioners to adopt the evidence and practice according to the evidence. The Perfusion Down Under (PDU) Collaboration addresses the first three. The fourth is more difficult, and it typically takes many years for new evidence to be adopted into widespread practice. In the case of innovations related to patient safety, evidence from randomized controlled trials is often very expensive to obtain. Other methods of evaluation may be more appropriate, but these do need to be robust and to take account of the constructs underlying the innovations and the context in which they are to be implemented. In the United States, The Institute for Healthcare Improvement (IHI) aims (among other things) to promote the adoption of best practices and effective innovations. The IHI has articulated a useful framework for doing this. Measurement is fundamental to quality improvement, and sustainable change is likely to be more readily achieved if claims are supported by credible, measurable, and clinically relevant outcome data. The PDU is well placed to support quality improvement in perfusion by providing such data.