Evidence-Informed Practice and Outcome Evaluation Standard

    The public can expect licensed healthcare professionals to base their health service decisions, recommendations, and actions on the best available evidence, informed by professional standards, clinical experience, and the individual needs, preferences, and values of their patients. Licensed healthcare professionals are responsible for monitoring the effectiveness of the health services they provide and making changes to those services when needed to improve outcomes and ensure safe and effective care.


    This Practice Standard applies to all aspects of professional decision making, including assessment, treatment planning, health service delivery, and evaluation of clinical outcomes.

    A licensee must:

    1. Use the best available evidence in their practice, which means to:


      1. Incorporate relevant and current evidence in their area of practice. 
      2. Integrate evidence with professional experience and the patient’s unique needs, preferences, values, and goals in planning and delivering care and services.
      3. Update their practice when evidence evolves, when new evidence becomes available, when professional guidelines are updated, and when concerns about the safety or effectiveness of specific health services are identified.
    1. Demonstrate proficiency in assessment and/or diagnosis, which means to:


      1. Select and employ assessment tools and procedures that are valid, reliable, and appropriate to the condition, needs, and cultural context of the patient or individual being assessed, drawing on current evidence, professional judgment, and clinical guidelines. 
      2. Use standardized measures where available and appropriate to assess and/or monitor the health condition and progress of the patient or individual being assessed.
      3. Adapt tools and procedures in consultation with the patient or individual being assessed where standardized assessment tools and procedures do not align with their cultural framework, risk causing harm or re-traumatization, use language or concepts that are inaccessible, or measure constructs that are not meaningful to their lived experience.
      4. Interpret assessment findings using critical thinking and evidence-informed reasoning to formulate conclusions about the condition of the patient or individual being assessed, including a diagnosis, where appropriate. 
      5. Ensure that clinical diagnoses are based on reliable data, clinical expertise, and the presentation of the patient or individual being assessed.
    1. Collect and use data to inform treatment which means to:


      1. Collect relevant health history and other relevant information from the patient or individual being assessed to inform decisions regarding assessments, diagnoses, treatment plans, and other interventions.
      2. Identify when additional information or data is required, including information from other healthcare providers or collateral information from family members and/or other relevant parties, and request that information with the patient’s consent or in compliance with privacy and confidentiality requirements.
      3. Recognize and critically assess the risks of misinformation and inaccuracies in the information and data collected.
      4. Follow up on tests, diagnostics, and referrals initiated by the licensee within a reasonable timeframe. 
    1. Provide services that are supported by evidence, which means to:


      1. Refrain from offering or providing health products or health services that will not meet the identified needs of the patient based on available evidence.
      2. Discontinue interventions that are no longer necessary or effective, or appear to be inappropriate or harmful, based on monitoring of the patient’s progress, review of their feedback, and evaluation of outcomes.
    1. Evaluate outcomes, which means to:


      1. Use appropriate methods to monitor the outcomes of health service decisions and interventions, and document in the patient record.
    1. Adapt treatment or care plans based on findings, which means to:


      1. In consultation with the patient, adapt the patient’s treatment or care plan when there is sufficient information to form the clinical opinion that the plan is not achieving the desired results.
    1. Unless prohibited or restricted by law or the terms under which a service was rendered, share findings with the patient, which means to:


      1. Communicate assessment results, diagnoses, and findings regarding treatment directly to the patient (or their substitute decision-maker) in a timely, respectful, and accessible manner.

    Consent: a voluntary, informed, and capable person’s agreement to receive a specific health service. Consent is valid only when:

    • The person is capable of making the decision;
    • The person receives the information that a reasonable person would require about the nature, purpose, benefits, risks, and alternatives to the proposed service;
    • The person is given an opportunity to ask questions and receive answers;
    • The decision is voluntary, not obtained through coercion, fraud, or misrepresentation; and
    • The consent relates to the specific health service proposed.

    Consent may be expressed orally or in writing, or inferred from the person’s conduct, and may be withdrawn at any time.

    Evidence: reliable and relevant information used to inform professional judgment or decision making. This may include research findings, clinical or professional experience, practice data, expert consensus, or Indigenous or community knowledge systems recognized within their cultural context.

    Evidence-informed: recognizing that evidence is one of several key inputs to professional judgment and decision making, balanced with contextual factors (such as ethics, values, or the needs of the patient or individual being assessed) to guide the final decision.

    Health service: any service or activity provided by a licensee in relation to healthcare, including collecting information; assessing, diagnosing, preventing, monitoring, treating, or managing a person’s health or health-related condition; or providing health-related information to an individual or the public, whether or not treatment is provided.

    Individual being assessed: an individual who is the subject of an evaluation, examination, or report prepared by a licensee for a third party (such as an employer, insurer, court, or agency).

    Patient: a person to whom health services are provided. Throughout the Ethics and Practice Standards, “patient” includes substitute decision-makers, parents, and guardians where applicable.

    Record: includes patient information, books, documents, drawings, photographs, letters, vouchers, papers, and any other thing on which information is recorded or stored by graphic, electronic, mechanical, or other means, but does not include a computer program or any other mechanism that produces records.

    Substitute decision-maker: a person who is legally authorized to make healthcare decisions on behalf of an adult who is incapable of giving or refusing consent, in accordance with British Columbia law. A substitute decision-maker may include, as applicable:

    • A representative appointed under a representation agreement pursuant to the Representation Agreement Act.
    • A committee of the person appointed by the court under the Patients Property Act.
    • A temporary substitute decision-maker selected in accordance with the Health Care (Consent) and Care Facility (Admission) Act.