The Centre for Evidence-Based Orthopaedics Tool for the Implementation of Evidence-Based Practice

Abstract

Introduction

Updating practices can be challenging in evidence-based practice when integrating the evidence, clinical expertise, and patient values and preferences. Implementing evidence-based practice requires individual, collective, and organizational behavioral changes. Effective behavior change interventions are necessary to facilitate the implementation of new evidence. We propose a tool to facilitate the implementation of evidence in clinical decision-making by changing healthcare providers' behaviors.

Methods

The Centre for Evidence-Based Orthopaedics (CEBO) tool was developed to bridge the gap between evidence and practice in a hospital department. The development process follows a Plan-Do-Study-Act (PDSA) structure and is based on the COM-B model (Capability, Opportunity, Motivation, Behavior) and the Theoretical Domains Framework (TDF), which recognize that effective behavior change necessitates addressing factors at both individual and organizational levels. The CEBO tool consists of four phases, guiding the process from identifying an evidence-practice gap to evaluating behavioral changes following implementation.

Results

We applied the CEBO tool to two surgical cases, which led to substantial behavioral changes in orthopedic surgeons' treatment choices. Our findings indicate that the CEBO tool is feasible and can influence surgeons' behaviors to align more closely with the best available evidence.

Conclusion

The CEBO tool helps align practice with the best available evidence. Although implementing new practices effectively is time-consuming, it seems achievable with the CEBO tool. Substantial behavioral changes were observed among surgeons in both cases.