CDC and Our Health Care

Now known as the Centers for Disease Control and Prevention, the Communicable Disease Center (CDC) started in this country in 1946 in order to investigate malaria in the southern states of America. The agency’s first mission was to prevent the spreading of malaria throughout America. Today, the CDC is a critical agency under the onus of the Department of Health and Human Serves and focuses on five strategic areas:

supporting state and local health departments; improving global health; implementing measures to decrease leading causes of death; strengthening surveillance and epidemiology; and, reforming health policies.

The CDC’s mission is to “keep Americans safe and healthy where they work, live and play. Scientists and disease detectives work around the world to track diseases, research outbreaks, respond to emergencies of all kinds, and use what they learn from this work to strengthen America’s health and resilience”
(https://www.cdc.gov/about/24-7/savinglives/index.html). Some examples of the public health efforts include: preventing and controlling infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats.

An important component of the CDC includes the advisory committees (a total of 24). The Federal Advisory Committee Act (Public Law 92-463) provided the means for experts and stakeholders to participate in the decision-making process, which includes advice and recommendations to the Federal government. The Federal Advisory Committees are overseen by the Congress, the President of the United States and the General Services Administrator (through authority delegated by the President). The committee programs include occupational and environmental health, healthcare infection control, clinical laboratory standards, and public health issues (smoking, breast and cervical cancer, Tuberculosis, childhood and adult immunizations, and injury prevention and control).
 
The CDC‘s major functions are:
1. Operates a 24/7 central command to monitor health and respond to health crises
2. Practice research that leads to the best solutions to fight disease and protect health
3. Provide proven, lifesaving ways to defend against health threats
 
The CDC serves as an important source for researchers, as well as our healthcare providers. Researchers obtain data about our nation’s health from the CDC in order to pursue and test their research in regard to many health issues. A common and critical term for researchers and healthcare providers is “evidence-based medicine.” It is important that we follow sound medical practices and not be distracted or misled by unethical and unproven approaches to medicine. The definition of evidence-based medicine (EBM) is defined by National Institute of Health as “the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information.”

This past December, there were rumors that the current President’s administration chose to place a ban on seven words utilized by the CDC. The CDC directors have since announced that this was a mischaracterization of the actual discussion during a budget meeting. Oddly enough, one of the terms included in the discussion was “evidence-based.” As previously defined, evidence-based is an essential term to describe the many approaches to medical practices, research methods, and various aspects of patient care. The proposed substitute description for evidence-based was described as “science in consideration with community standards and wishes,” which lacks clarity and does not provide users with a practical functional term.
(http://www.newsweek.com/trump-bans-cdc-using-these-seven-words-750383).
Since this report, the CDC claims that are not changing any of their practices.

Evidence-based practices (EBP) is embedded in the field of health. In Becker’s Hospital Review for the American Hospital Association, evidence-based practices has shown to enhance patient safety, reduce medical errors, decrease patient need for medications, reduce staff injuries, and increase staff efficiency through improved workflow  (https://www.beckershospitalreview.com). The America Nurses Association has noted: “The impact of evidence-based practice (EBP) has echoed across nursing practice, education, and science. The call for evidence-based quality improvement and healthcare transformation underscores the need for redesigning care that is effective, safe, and efficient” (OJIN, Online Journal of Issues in Nursing). The American Physical Therapy Association recognizes the need for EBP in order to provide high-quality care, along with social workers, respiratory therapists and the numerous other health care divisions.

Other fields outside of medicine utilize the term – evidence-based – including businesses when referencing good management style. Like medicine, evidence-based management is based on critical thinking and the best available evidence. Community and social organizations also use evidence-based practices to improve outcomes. For example, evidence-based models are used to combat homelessness or to build safe and healthy communities.

It would be detrimental to healthcare if evidence-based medicine was not utilized because it includes the following components critical to patient care: (https://library.med.nyu.edu/library/instruction/handouts/pdf/ebmdefinitions.pdf)
1. Formulate a clear clinical question from a patient's problem
2. Search the literature for relevant clinical articles
3. Evaluate (critically appraise) the evidence for its validity and usefulness
4. Implement useful findings in clinical practice