Background: Decision makers in hospitals and healthcare systems use research evidence to inform decision making, but little is known about these research evidence needs.
Objectives: The Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) programme sought to characterise the research evidence needs of hospital and healthcare system decision makers in the US to ensure that production of evidence syntheses aligns with decision-makers’ needs.
Methods: We examined evidence reviews produced by three US-based healthcare organisations:
• ECRI Institute, which offers a health technology assessment information subscription service (HTAIS);
• the Veteran’s Health Administration’s Evidence-based Synthesis Program (VHA ESP), providing evidence for the largest integrated health care system in the US;
• Penn Medicine Center for Evidence-based Practice (CEP), serving an academic healthcare system.
Evidence review characteristics examined included: requestor types, report types, clinical specialties and technology classes examined, and other characteristics including synthesis methods and dissemination approaches.
Results: ECRI’s HTAIS received 700 requests in 2016, 307 (44%) of which came from hospitals or health systems in the US (median 4.5 hospitals per system, range 1 to 34). Of the hospitals, 20% were rural, 27% had <100 beds, and 31% had no academic affiliation. Of the systems, 61% were moderately or highly centralized. The Table describes the characteristics of the ECRI reports, as well as those produced by the VHA ESP and the Penn CEP. A wide range of clinical and administrative decision makers request evidence reviews, and the topics are similarly broad ranging from evidence to guide: clinical care; purchasing of medications and devices; procedural and non-procedural interventions; and processes of care.
Conclusions: Hospitals and healthcare systems have diverse needs for research evidence with multiple requestors. Adapting the production of evidence syntheses to efficiently meet this need is likely to be one of the biggest challenges facing organisations that provide evidence reviews for healthcare systems.