To better control health care costs, the effectiveness of care should be proven by scientific evidence
One of the precursors of evidence-based clinical practice was without a doubt Archibald Cochrane, known for his influential 1972 book, Effectiveness and Efficiency – Random Reflections on Health Services. In the book, he explains that the resources available for health care will always be limited and that they should be used to provide care proven by research to be clinically effective. He also urged professionals to weigh the costs of providing the care against the benefits. Forty years on, his arguments are still valid.
As international support for this movement grew, initiatives were created to produce rigorous methods and standardised tools for measuring the effectiveness and analysing the cost-benefit ratio of health care interventions. Both the Cochrane Collaboration Centre and the Joanna Briggs Institute have established branches in a number of countries, including Switzerland. And the National Institute for Health and Care Excellence in the United Kingdom has been used as a model for several national institutes that promote effective and efficient clinicalpractices. The movement raised research standards for all health professionals, allowing them to take better account of the effectiveness of their interventions. It also increased the involvement of patients and families, who began to play an essential role in complex decision-making.
However, a number of barriers to evidence-based clinical practice have also been identified. Among them, the lack of experience in research is one of the most limiting. The University Institute of Training and Research in Patient Care in Lausanne was founded by seven French-speaking Swiss partners to help increase the effectiveness of care for the non-medical health professions. It offers master’s and PhD programmes, develops structured research programmes and promotes local, national and international collaboration devoted to research on innovation, effectiveness and efficiency.
In addition to providing guidelines for integrating a cost-benefit analysis into the decision-making process, evidence-
based clinical practice fosters leadership, accountability, innovation and collaboration between health professionals, patients and their families.