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Evidence-based Practice Committee Report Spring 2006

The Evidence-Based Practice Committee, established in June 2005, is a joint committee of the Board of Directors and House of Delegates. The charge of the EBP Committee is to oversee the development and implementation of evidence-based practice, including the evidence analysis process development and maintenance of the Evidence Analysis Library, development and publication of all Evidence-Based Guides for Dietetics Practice (including those for Medical Nutrition Therapy) and other products based on the results of evidence analysis. Below you will find the progress of the EBP Committee since June 2005:

General Operating Activities

The Committee has conducted seven conference calls and two meetings to manage committee business.
The Committee approved the Program of Work for 2005 to 2006 and is working toward achieving all goals.

Activities Related to Evidence Analysis Process and Workgroups

The Committee developed the procedure and criteria for the selection of Evidence-Based Guideline Workgroups. A sub-group of the Committee was identified to manage workgroup selection, and has thus far initiated three new workgroups (including unintended weight loss, non-nutritive sweeteners and chronic obstructive pulmonary disease workgroups) and appointed nine other members to various workgroups.
The Committee developed a plan for annually surveying evidence-based guideline workgroups in order to identify any inefficiency with the evidence analysis process.
Seven Committee members were trained as evidence analysts during a two-day Evidence Analysis Workshop.

Activities Related to Guideline and Toolkit Development

The Committee determined the Purpose, Principles, Priorities and Funding of Evidence-Based Guidelines and Toolkits for Dietetics Practice.
The Committee determined the content and titles of future Evidence-Based Nutrition Practice Guidelines and Toolkits.

Evidence-Based Nutrition Practice Guidelines: An ADA online resource which contains systematically developed recommendations, based on scientific evidence, designed to assist practitioners and patient decisions about nutrition care for specific diseases or conditions.

Toolkits: A set of companion documents which specifically detail how the practitioner applies the Evidence-Based Nutrition Practice Guidelines in practice, and includes the MNT protocol, documentation forms, client education resources and outcomes monitoring forms.

The Committee developed a plan for creating Toolkit templates. Three sub-groups of the Committee have completed documentation, outcomes monitoring and client education templates.
The Committee facilitated the development of the Disorders of Lipid Metabolism Toolkit. The Toolkit is undergoing a usability test and will be published online in June 2006.
The Committee will review and approve the Adult Weight Management Evidence-Based Guideline for publication in May 2006.
The Committee approved a project timeline for Evidence-Based Guidelines and Toolkits and will facilitate the development of guidelines for critical illness, pediatric weight management, oncology, hypertension and heart failure in the coming fiscal year.
The Committee identified the need to survey members using the Evidence-Based Guidelines to determine their usefulness and influence on practice. The objectives and potential channels for the survey were determined.
The Committee revised the Recommendation Rating Scheme used in the development of Evidence-Based Guidelines.
The Committee identified a model for the review process of Evidence-Based Guidelines and Toolkits.

Collaborations

The Committee developed a definition for Evidence-Based Dietetics Practice, in collaboration with the Quality Management, Research and Scope of Dietetics Practice Advisory Opinion Committees, and requested that it be added to the Scope of Dietetics Practice Framework Definition of Terms.

Evidence-Based Dietetics Practice is the use of systematically reviewed scientific evidence in making food and nutrition practice decisions by integrating best available evidence with professional expertise and client values to improve outcomes.

Key Considerations:

Evidence-based dietetics practice is consistent with the general definition and key considerations of “Evidence-Based Practice” in healthcare outlined in the ADA Scope of Practice Dietetic Framework Definition of Terms.

Evidence-based dietetics practice is based on the best available evidence including research, national guidelines, policies, consensus statements, expert opinion and quality improvement data.

The determination of “best available evidence” is based on the hierarchy of evidence. (www.adaevidencelibrary.com/topic.cfm?cat=1231)

The systematic review of scientific evidence is an ongoing process.

Evidence-based dietetics practice involves continuing evaluation of outcomes which becomes part of the evidence base.

Evidence-based dietetics practice applies to individual clients, customers and communities.

Evidence-Based Guidelines for dietetics practice are available at
www.adaevidencelibrary.com/.

The Committee determined a process by which each disease-specific toolkit would be developed and pilot tested through the Dietetics Practice-Based Research Network. The usability (pilot) test protocol has been developed, and the Disorders of Lipid Metabolism Toolkit usability test is currently underway.
The Committee, in collaboration with the QM Committee, revised the DPG policy on Development and Approval of Quality Management and Evidence-Based Projects. The Committee will present the policy to ADA Board of Directors for approval at the April 30 to May 1, 2006 meeting.
The Committee is conducting a pre-meeting educational session in collaboration with the QM Committee at the Spring 2006 HOD Meeting to promote evidence-based dietetics practice and present the newest evidence-based resources.

Communications

The Committee identified the target audiences and key messages for the communication plan of Evidence-Based Guidelines and Toolkits, and is working with the ADA Marketing Team to determine the best path for promoting these resources. Thus far, communications included articles for Evergreen Society, ADA Times, House Calls, Inside ADA, DPG electronic mailing list, CEO Digest, Affiliate Update and Behind the Scenes at ADA.
The Committee disseminated a message to DPG leaders in order to describe Committee goals and to enhance the collaborative relationships with DPGs.
The Committee members distributed informational flyers regarding evidence-based dietetics practice during several DPG functions at FNCE 2005.
The Committee Vice Chair presented information on evidence-based dietetics practice at the DPG/PID and ADA Spokespersons meetings during FNCE 2005.
The Committee promoted the Online Evidence-Based Guidelines at several functions during FNCE 2005, including the State Affiliate meeting and at the Online Product Demonstration Theater.
The Committee supported an educational session related evidence-based practice at FNCE 2005, “The Latest in Hyperlipidemia and CHF: What’s the Evidence for MNT?”
The Committee will support two educational sessions related evidence-based practice at FNCE 2006, “Putting Evidence-Based Guidelines into Practice: Examples from Critical Illness and Oncology” and “Developing Evidence-Based Guidelines Using the Nutrition Care in Bariatric Surgery Workgroup Process as a Model.”
The Committee Chair will present on “Nutrition Practice Guidelines” at the American Diabetes Association 66th Scientific Sessions in Washington, DC in June 2006.

More detailed information is available at www.adaevidencelibrary.com/. For additional information, please contact Kari Kren at kkren@eatright.org or 800/877-1600, ext. 4877.

Evidence-Based Practice Committee Members 2005 to 2006
Elvira Q Johnson, MS, RD, CDE, LDN, Chair
Marion J Franz, MS, RD, CDE, Vice Chair
David Frankenfield, MS, RD
Rita M Johnson, PhD, RD, LDN, FADA
Susan H Laramee MS, RD, LDN, FADA
Nancy M Lewis, PhD, RD, FADA
Kathleen C Niedert, MBA, RD, LD, FADA
Monica A Penkilo, MPH, RD, LD, CDE
Kimberly Robien, PhD, RD, FADA, CNSD
Margaret J Tate, MS, RD
Kari Kren, MPH, RD, LD, ADA Staff Partner

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