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Step 4, continued: Communicating Your Recommendation

Going back to an example that was used earlier in the course, imagine that you are called by your GI department and you are asked to bring in a new laboratory test that measures stool calprotectin levels. You know that your laboratory sends out 30-40 of these tests to a reference lab each month. Should you now start performing this test in-house, in your own lab?
You have now undertaken an evidenced-based review of the clinical benefits and the practicality of bringing stool calprotectin testing in-house. Based on your review, you decide to recommend this change. You must now compile your conclusions in a coherent and effective way so that you can communicate them and garner the needed support. Rather than writing pages of text or dozens of PowerPoint slides, consider doing the following:
  1. Write a one-page summary of your research assessment. List citations that evaluated best practices. For our example, this would entail a brief summary of the latest research on the sensitivity and specificity of the calprotectin test you plan to purchase and how it can be used to positively affect patient outcomes, experiences, or cost. Always cite references and make copies of research articles available.
  2. On a separate document list the people in your organization who have endorsed, or will need to endorse this change (for example, the Chief of Gastroenterology, other GI clinician sponsors, the laboratory manager, the lab's CLIA director, the purchasing or accounts manager, and the LIS or informatics manager of the lab). This document may be (or may become) an institutional form that can be used by stakeholders to formally sign-off on a proposed change.
  3. Draft a simple flow diagram that describes the proposed process starting with test order (how will the order look to the clinician, who can order it, and how will the result be reported to the clinician?). All the handling, transport, and other steps in the process should be summarized on this one diagram
  4. Provide a brief business case for your proposal. In our example this would mean clearly listing the cost of internalizing this test compared with the current practice of sending it out.

Once you have these four documents completed, you can circulate the proposal in a formal way to get buy-in from all affected parties. While the EBP aspect of the change is usually focused only on the first research page, the other documents and steps will help to summarize the overall plan.