by Sapna Dalal, MHSA; Lewis Flint, MD, FACS;
and Kathleen Heneghan, MSN, RN, CPN
Resources for optimal patient care:
EBDS and patient education programs
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In our continuing effort to provide information about all the benefits of membership in
the American College of Surgeons
(ACS), this month’s column
spotlights two resources that may
contribute to your daily practice
and the delivery of optimal patient
care: Evidence-Based Decisions in
Surgery (EBDS) and the College’s
patient education programs.
EBDS
Since its inception more than
100 years ago, the ACS has been
dedicated to helping surgeons
obtain the knowledge needed to
provide the highest quality care
to their patients. High-quality
surgical practice is both a science
and an art. The art emerges
through dedication to ethical
practice, empathy and respect
for the patient and his or her
preferences, and the delivery of
compassionate care. The science
of surgery requires a lifelong
commitment to learning.
An increasing emphasis
is being placed on the use of
evidence-based practices in
the delivery of health care.
Clinical practice guidelines
offer high-quality evidence
that surgeons can apply in
daily practice. Guidelines often
are developed by government
agencies, professional medical
organizations, and research
groups to facilitate the
implementation of evidence-
based practice by individual
practitioners, practice groups,
and health care institutions.
The ACS, for example, has
developed practice guidelines
for use in surgical practice—
the EBDS program.
What are clinical practice
guidelines?
The core objective of evidence-based practice is to standardize
the application of scientific
knowledge at the point of care.
Standardization is a process
that is intended to decrease the
inappropriate variation that
negatively affects quality, safety,
and cost-effective surgical care;
decreasing this variation should
be synergistic with promoting,
not stifling, innovation. One
important function of clinical
practice guidelines is to add
ease to the process of reducing
variation in practice.
Clinical practice guidelines
are developed by government
agencies, such as the U.S.
Preventive Services Task Force
and the National Institute for
Health Care and Excellence,
UK. Most practice guidelines are
developed by professional medical
organizations, including the
American Heart Association, the
National Comprehensive Cancer
Network, the Society of American
Gastrointestinal and Endoscopic
Surgeons, the Society for Surgery
of the Alimentary Tract, and
the Eastern Association for the
Surgery of Trauma. Independent
research groups, including the
Surviving Sepsis Campaign, also
produce practice guidelines.
Producing clinical practice
guidelines begins with
identification of the clinical
problem(s) to be addressed,
followed by assembling the
evidence. In this stage, the
focus is on available prospective
randomized trials, meta-
analyses of multiple trials, and
strong observational studies.
When the evidence available
in the literature is insufficient,
expert opinion is gathered from
the proceedings of meetings
designed to gather, evaluate,
and publish expert opinion. The
evidence is then graded using
YOUR ACS BENEFITS
