Redefining Evidence-Based Practice Through Patient Values: A Theoretical Innovation for Person-Centered, Value-Based...

Before evidence-based practice (EBP) was formally adopted, healthcare decisions relied on critical thinking and clinical judgment informed by disciplinary knowledge, theory, and research, but lacked full integration of patient values with clinical expertise. Sackett et al. redefined EBP as the integration of the best available evidence, clinical expertise, and patient values. This framework has been embraced by nursing and other healthcare disciplines, embedding EBP into education, clinical protocols, and quality improvement efforts. Despite widespread adoption, traditional conceptualizations prioritize empirical evidence above patient values, potentially undermining individualized care.

This paper proposes a reconceptualization that places patient and client values-their why-at the center of EBP, inspired by Simon Sinek's Golden Circle model which emphasizes starting with purpose to influence behavior effectively. Prioritizing the patient's values before incorporating empirical evidence into a care plan ensures that care aligns with their personal goals and definitions of health, fostering therapeutic relationships and supporting meaningful behavior change.

A conceptual analysis was conducted using Simon Sinek's Golden Circle model as a guiding framework. This model emphasizes starting with purpose to influence behavior effectively. The analysis explores how integrating patient values first, followed by empirical evidence and clinical expertise, can operationalize person-centered EBP.

The reconceptualized framework positions patient values as the foundation of care planning. By aligning interventions with patients' personal goals and values first, clinicians can strengthen therapeutic relationships and support individualized care.

Effective nursing clinicians and leaders must embrace this patient-first approach to truly operationalize person-centered, evidence-based care that respects the diverse needs and motivations of patients.