What is Evidence-Based Practice?

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Evidence-based practice (EBP) is an approach to patient care that integrates the best available research evidence, the expertise of the healthcare provider, and patient values.  EBP benefits everyone, including nurses and patients, employers, and insurers, by improving health outcomes, enhancing patient experiences, reducing healthcare costs, and improving the well-being of the healthcare team. Providing clinicians with the EBP tools necessary to identify problems, access important research, make diagnoses, and brainstorm solutions also establishes standards for safety measures.  We recognize that over time, the science and evidence base continue to expand and change.  This is why we will provide updates on any treatment Improvement protocols, guidance documents, clinical practice policies, toolkits, and other actionable materials as they become available.   This strategy will help to guarantee that communities and practitioners are better equipped to bring about the improvements in maternal health that Native women should always be aware of and have access to. At Bass, United, we are committed to taking the necessary steps to improve maternal health for all Native women by pursuing and endorsing evidence-based practices as a cornerstone of this endeavor.

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The goal of this section is to bring awareness of the currently established guidelines and toolkits that healthcare providers are required to use and follow when providing care to women, especially Native women, during pregnancy.  Since there is much publicity surrounding the increased maternal morbidity (disease states) and mortality (death) data in BIPOC women (Black and Indigenous People of Color), we will begin with the focus on addressing the maternal health and healthcare disparities (unequal, unfair) that Native women have been challenged with. 

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We will use a blog roundtable platform to present, each month, one evidence-based clinical guideline focused on the management of a specific maternal health condition.  The intent is to provide a forum for Native women to share comments, critiques, interpretations, and/or recommendations on the maternal health topic, the nature of the research, and/or the clinical guideline.  It is a safe, confidential forum where community members may use an “avatar” name to remain anonymous if they choose.  Medical or health-related blogs have the potential to serve as informational tools about the personal experiences of the women served by the very same providers who use these clinical guides, and which, in turn, can be crucial for improving their healthcare. 

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It is a given that women of color have special needs, both based on their ancestral history, their social determinants of health, their culture, and their gender. Research and clinical practice may not necessarily address these needs and thus result in evidence and practice that are not truly representative of women. Blogs characterized by reflective, descriptive, interpretive, and exploratory content written by the women themselves would best inform how they should be cared for. Blogs have a place in translating research, making a significant contribution to improving health and health equity.  Blogs can also create circles of women who may want to share experiences, whether positive or negative, as examples for others to learn from and work with toward healing.

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We will begin with one of the most widely used maternal health frameworks today – maternal care bundles developed by the Alliance for Innovation on Maternal Health (AIM) program, a cooperative agreement between the American College of Obstetricians and Gynecologists (ACOG) and the Health and Human Services Administration Maternal-Child Health Bureau (HRSA-MCHB).  The Council on Patient Safety in Women’s Health Care also collaborates with the AIM program to design and deliver tools and resources that enhance education for maternal healthcare providers through its site, Patient Safety Bundles. 

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The maternal health topics are designed to educate providers and provide interested organizations with a way to conduct quality improvement using one or more of the bundles.  For our website launch, we will begin by examining and discussing two of the supporting bundles. The first is the Reduction of Peripartum Racial/Ethnic Disparities, and the second, which is more extensive but nevertheless critical in maternal health, is Maternal Mental Health: Perinatal Depression and Anxiety.  

For the Maternal Mental Health bundle, there are 3 additional toolkits that outline all of the specific steps for Obstetric, Pediatric, and substance use providers to follow when caring for pregnant women with mental health challenges, including in the postpartum (after birth) period.  These toolkits can be found at the Massachusetts Child Psychiatry Access Program site (https://www.mcpapformoms.org/Toolkits/Toolkit.aspx). 

The complete toolkits can be downloaded here:  https://www.mcpapformoms.org/Docs/AdultProviderToolkit12.09.2019.pdf .

Feel free to download all this information, review it with a nice cup of coffee or tea and a big blanket, then share your thoughts, critiques, concerns, questions, or recommendations for change, if needed, in any of the information within the toolkits.  Your input regarding tradition and culture, which you can offer, contributes greatly to improving and refining existing and new Western conventional research and practice – two paradigms of health - when, in a mutually beneficial partnership, they can create a powerful healing force for the greater good.