Evidence-based practice: a model for clinical application

Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care. Published meta-analyses and systematic reviews provide clear, unbiased evidence on the effectiveness of specific interventions. Yet translating the interventions into the practice setting requires additional clinical skills and judgments extending beyond the scientific assessment of the EBP literature. Effective use of EBP interventions requires clinicians effectively answering an additional set of questions specific to the case and clinical context. These questions focus on correctly identifying the problem and increased level of specificity for any given situation. Using a clinical application of the PICO model, the clinician and the patient should be able to achieve a higher level of clinical outcomes.