The actual strategies for implementing evidence-based medicine require an evidence base of their own. Using implementation strategies that are evidence-based is called evidence-based quality improvement (EBQI). Implementation strategies that are evidence-based include performance feedback, leadership support, external and internal facilitation (sometimes called a clinical champion), provider and patient education, tailoring to the local context, using a quality manager, and regular data collection to drive and evaluate change. EBQI is best when it is a true partnership between researchers, clinicians, and clinic leadership. Clinicians and administrators contribute the local knowledge needed to tailor the evidence-based practice for their own particular needs and organizational capabilities.
Of note, the lack of support from leadership has been shown to be one of the most important barriers to the implementation of a new service. Researchers contribute knowledge of the evidence base; ensure fidelity to the evidence base; and supply materials, procedures, and tools the EBQI model also facilitate problem solving and provide ongoing technical support for developing data collection/analysis tools, informatics, and training materials. While emphasizing the involvement of outside experts and empirical evidence, EBQI stresses that an organization’s own healthcare professionals and staff are best positioned to improve their systems. One of the most important components to successful EBQI supporting implementation of evidence-based practices is continuously revising the adjustments to implementation through Plan-Do-Study-Act cycles.