JBI APPROACH TO EBHC
THE JBI MODEL OF EVIDENCE-BASED HEALTHCARE
JBI’s approach to evidence-based healthcare is unique. JBI considers evidence-based healthcare as decision-making that considers the feasibility, appropriateness, meaningfulness and effectiveness (FAME) of healthcare practices.
Culture - Capacity - Communication - Collaboration
The JBI Model
The JBI Model of Evidence-based Healthcare was developed in 2005 and updated in 2016.
- The inner circle represents the pebble of knowledge while the 'inner wedges' provide the Institute’s conceptualisation of the steps involved in the process of achieving an evidence-based approach to clinical decision-making.
- The 'outer wedges' operationalise the component parts of the model and articulate how they might be actioned in a pragmatic way.
- The arrows indicate that the flow can be bi-directional.
Centred Red Pebble
The inner circle represents evidence-based healthcare. Health professionals require evidence to substantiate a wide range of activities and interventions. When making clinical decisions, health professionals are concerned with whether their approach is Feasible, Appropriate, Meaningful and Effective (FAME).
Global Health: Defined as collaborative, trans-national research and action that places a priority on improving health and achieving health equity for all people worldwide
The evidence generation wedge of the Model identifies discourse (or narrative), experience and research as legitimate means of knowledge generation. It recognises that the results of well-designed research studies grounded in any methodological position, anecdotes or personal opinion and expertise are all deemed valid methods of generating evidence to inform policy and practice.
Evidence synthesis is the evaluation or analysis and collation of research evidence and opinion on a specific topic to aid in decision-making in healthcare. The three main components of this wedge are systematic reviews, evidence summaries and guidelines.
Fundamental to the process of evidence-based decision-making is the ability of those at the point of care to access synthesised research evidence. Evidence transfer is the coactive, participatory process to advance access to and uptake of evidence in local contexts. It is a causal phenomenon consisting of factors that enable, facilitate and support evidence implementation that is more than just a single interaction. It incorporates active dissemination, systems integration and education.
Evidence implementation is a purposeful and enabling set of activities designed to engage key stakeholders with research evidence to inform decision-making and generate sustained improvement in the quality of healthcare delivery. Components of evidence implementation include a context analysis, the facilitation of practice change and evaluation of process and outcome.
JBI's approach to evidence-based healthcare is unique. JBI considers evidence-based healthcare as decision-making that considers the feasibility, appropriateness, meaningfulness and effectiveness of healthcare practices.
The best available evidence, the context in which care is delivered, the individual patient and the professional judgement and expertise of the health professional inform this process. JBI regards evidence-based healthcare as a cyclical process. Global healthcare needs, as identified by clinicians or patients/consumers, are addressed through the generation of research evidence that is effective, but also feasible, appropriate and meaningful to specific populations, cultures and settings.
This evidence is collated and the results are appraised, synthesised and transferred to service delivery settings and health professionals who utilise it and evaluate its impact on health outcomes, health systems and professional practice.
Therefore, in order to provide those who work in and use health systems globally with world class information and resources, JBI:
- considers international evidence related to the feasibility, appropriateness, meaningfulness and effectiveness of healthcare interventions (evidence generation)
- includes these different types of evidence in a formal assessment called a systematic review (evidence synthesis)
- globally disseminates information in appropriate, relevant formats to inform health systems, health professionals and consumers (evidence transfer)
- has designed programs to enable the effective implementation of evidence and evaluation of its impact on healthcare practice (evidence implementation).
It is this unique approach that is encompassed in the JBI Model of Evidence-based Healthcare.
Jordan Z, Lockwood C, Aromataris E, Munn Z. The updated JBI model for evidence-based healthcare. The Joanna Briggs Institute. 2016
Pearson A, Jordan Z & Munn Z. Translational science and evidence-based healthcare: a clarification and reconceptualization of how knowledge is generated and used in healthcare. Nursing Research and Practice. 2012.
Pearson A, Wiechula R, Court A & Lockwood C. The JBI model of evidence‐based healthcare, International Journal of Evidence‐Based Healthcare. 2005; 3(8):207-215.
JBI Methodology Groups
Scientific development is an important priority for JBI. For more than 20 years, JBI has been a world leader in providing methodological guidance for the conduct of systematic reviews and evidence implementation. JBI achieves this via its Methodology Groups, comprising experts from across JBI and the JBI Collaboration to examine its methodologies for the conduct of systematic reviews of different types of evidence.