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Example Potential for use of evidence to enhance authority and accountability for practice. The word "evidence" relates to what is manifest and apparent and involves -clarity, obviousness, -information given personally, or drawn from documents etc.

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Involves actions or information that can be independently observed and verified. Which are expected? PICO What need will a change in practice meet?

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How important is the topic? How closely does the proposed change fit with the environment? What is the level of evidence that supports the proposed change or problem? Who needs to be involved? Enhancing the efficacy of heart surgery by optimizing patients' preoperative expectations: Study protocol of a randomized controlled trial.

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Am Heart J. In coronary heart disease CHD and heart surgery, there is sound evidence for the relationship between patients' expectations and treatment outcome, especially for outcome variables such as disability and quality of life. In addition, patients' expectations have been shown to be modifiable through psychological interventions.

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Therefore, targeting patients' expectations might offer a promising opportunity to enhance heart surgery outcome. However, few studies have tried to actively change patients' expectations before surgery. The purpose of this clinical trial is to optimize patients' outcome expectations before undergoing coronary artery bypass graft surgery CABG through a brief psychoeducational program.

The present article describes the study protocol and reports preliminary data on feasibility. The main goal is to test a whether expectation manipulation intervention can optimize patients' expectations and b whether optimized expectations lead to enhanced surgery efficacy. The primary outcome variable is illness-related disability 6 months after surgery, whereas secondary outcome variables will be quality of life, return to work, physical activity, and medical outcome variables. First, feasibility data of 36 patients show that the patients appreciated the additional psychological intervention before CABG.

Satisfaction of those who received psychological interventions was very high.

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Agency for Healthcare Research and Quality — www. Philip M. Ullrich, Ph.

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