constraints within their local economies . Local governments in particular have been at the forefront of managing the impacts of the changes brought about by COVID-19 within our communities ( Wilson et al ., 2020 ). Across the United States many cities responded through initiatives such as new websites for COVID-19 relief efforts , campaigns to increase local spending , and new grant programs ( Wilson et al ., 2020 ). Local governments in Australia too have actively responded with similar programs . With the impact of the pandemic being so widespread , there is an increased benefit in having organisations that are positioned to deploy resources that reflect the unique needs of different cities and regions .
Communities all around the world have had to adapt and deal with challenges they had not previously encountered , and to source and implement novel solutions and policies . The uncertain and evolving nature of the pandemic has shattered the notion that we can continue to act with the same sense of certainty about ‘ what works ’ ( Lancaster et al ., 2020 ). It can be expected that at some point the tug-of-war between economic and health priorities will increasingly shift to emphasise economic recovery , as medical and scientific efforts find success in mitigating the spread of the virus . It is imperative that the economic development practitioners and economic policymakers preparing to navigate this unchartered territory in the aftermath of the COVID-19 pandemic , are equipped with a framework that allows for the integration of new information and evidence as it becomes available . Evidence-based practice models , such as the John Hopkins Nursing Evidencebased practice ( EBP ) model may provide an opportunity for local economic development organisations to take inspiration from the front line workers who have played a key role in the health response .
EVIDENCE-BASED PRACTICE NURSING MODEL Evidence-based practice ( EBP ) is a problemsolving approach to the delivery of health care that seeks to integrate the best evidence from studies and patient care data with clinician expertise and patients ’ preferences and values ( Melnyk et al ., 2012 ). To view this from an economic development perspective it would involve approaching challenges in the local economy through integrating the best available research and evidence , with the expertise and knowledge of practitioners , and the values of the communities in which they work , in order to achieve improved economic and social outcomes . There are numerous evidencebased practice approaches and frameworks that have been developed , such as the John Hopkins nursing evidence-based practice model which was designed specifically to help nurses translate evidence into practice . The process of incorporating new knowledge into clinical practice is often considerably delayed , which means that more is known than is practiced ( Dang et al ., 2018 ).
The John Hopkins nursing EBP model follows an explicit three step process ( Dang et al ., 2018 ): 1 . Identify the practice question . 2 . Identify the best evidence to answer question . 3 . Translate the evidence to practice .
The most crucial step in the process is to identify the problem , which requires being consistently inquisitive and asking ‘ why ’ – why are we doing it this way ? Is there a better way ? How can we improve an outcome ? What is this like for the ‘ patient ’? ( Hain & Kear , 2015 ). Once the problem has been clearly identified and articulated , the process of gathering the best available evidence to answer this question begins , and finally this evidence is translated into practice .
Figure 1 : Evidence-Based Practice model
Clinical Experience
Best Available Evidence
' Patient Values '
BEST AVAILABLE EVIDENCE The concept of an increased use of evidence in the development of publicpolicy is not a new notion . Public sector leaders in the United Kingdom have been advocating for increased used of evidence in public-policy making for many years ( Newman et al ., 2017 ) The central principle behind the use of evidence in policy development is that it should be used to indicate whether or not a particular policy will achieve its objects , what specific outcomes it will produce , and how much it will cost to implement ( Newman et al ., 2017 ). Being able to demonstrate and justify the expected outcomes is important to ensure that intervention taken does not lead to adverse outcomes – such as a patient being prescribed the wrong course of treatment or medication . In 2016 , America ’ s National Academy of Medicine highlighted the importance of evidence in quality decision making by setting the goal that 90 % of all clinical decisions would be supported by the best available evidence by the year 2020 ( Connor , 2018 ).
In the United States , many nursing education programs emphasize a rigorous process of how to conduct research as opposed to how to translate research and clinical data into an evidence-based approach . This has led to negative attitudes towards utilising research in practice and has resulted in care being based on past academic learnings or outdated policies and procedures ( Melnyk et al ., 2012 ). Similarly , a survey of over 2,000 Australian public servants in 2017 revealed that the public service may be structurally unprepared for an engagement with diverse forms of evidence – particularly academic research ( Newman et al ., 2017 ). There are bound to be challenges in implementing complex research and evidence , particularly when it relates to an area outside of one ’ s field of expertise . It is important to take a realistic approach to the concept of ‘ best available evidence ’ to ensure that an evidence-based practice framework for economic development is effective . The term best available evidence suggests the use of the strongest and most relevant evidence available , as opposed to only utilising evidence of the highest quality , relevance , and abundance ( Slocum et al ., 2012 ). This has been particularly true following the outbreak of COVID-19 , as the nature of the rapid decision making required continue to challenge the idea of what constitutes ‘ evidence-enough ’ ( Lancaster et al ., 2020 ).
INDIVIDUAL CLINICAL EXPERTISE Appropriate evidence is crucial to the development of effective initiatives , but expertise also plays a key role in ensuring that evidence can be translated into practice . One of the early pioneers of evidence-based medicine , Dr David Sackett ( 1996 ) remarked that “ Good doctors use both individual clinical expertise and the best available external evidence , and neither alone is enough ”.
Compared to humans , companies and regions can vary dramatically in size , form and shape which means it can be risky to presume that a proven ‘ cure ’ that was successful in one place would work somewhere else ( Pfeffer & Sutton , 2006 ).
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