A Framework of Evidence-Based Decision-Making in Health System Management: Applying Best-Fit Framework Synthesis

Abstract

Background: Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. In recent years, efforts have been made to create more comprehensive guidelines for evidence-based decision-making (EBDM), thus the purpose of the present study was developing a framework for EBDM to make the best decisions concerning to scare resources and too many needs. Methods: The present basic-applied research was a secondary study carried out using qualitative research method in 2019. A Systematic Scoping Review (SSR) was done for the comprehensive review of the existing published studies in this area. This method, according to Arksey and O’Malley approach, consists of five main stages and one optional stage. Results: Based on the SSR, 3751 studies from 7 databases were found, and due to the full-text screening of the studies, 30 final studies were selected for extracting the components and steps of EBDM in Health System Management (HSM). After collecting, synthesizing, and categorizing key information, the framework of EBDM in HSM is developed in the form of four general scopes of inquiring, inspecting, implementing and integrating, which includes 10 main steps and 56 sub-steps. Conclusions: The present framework tries to present a sequential systematic map to achieve evidence-based decision and policy making specially for under developed and developing countries which mostly suffer from applying update and applied evidences in their decision-making process. At the same time, it seems that the present framework tries to synthesize and integrate the fragmented elements of the other models and in this way can be tested by developed countries to improve their EBDM cycle.