EVOLVE is a physician-led initiative that encourages each medical specialty to think about the clinical circumstances in which some of their practices - whether medical tests, procedures or interventions - should have their indications or value questioned and discussed by physicians. These practices may be overused, inappropriate or of limited effectiveness in a given clinical context.
As its name suggests, it recognises that medical practice is dynamic; continually improving based on evidence and experience. EVOLVE is one stream of a growing international movement aimed at delivering high-quality care and decreasing the use of unnecessary interventions. You can learn more about the EVOLVE initiative by reading our Frequently Asked Questions.
Partnership & Principles
EVOLVE is a joint initiative of the RACP and its associated Specialty Societies, with an agreed framework in place that outlines the partnership and seven key principles that guide it.
At its core is the identification of clinical interventions that, in a given clinical context, add little or no value to patient care. This work involves an in-depth review of the evidence combined with the experience and expertise of specialist physicians, and follows a rigorous methodology developed specifically for EVOLVE.
How Specialties can get involved
Specialties and physicians wanting to get involved can access a range of resources and support that is available from the RACP. This can range from research to identify ‘low-value’ items and facilitating cross-specialty discussions, through to partnering to develop communication and educational resources to support the lists’ recommendations.
There are three broad steps to developing your specialty's Top 5 list of low-value interventions:
- Collate an initial list of possible low-value interventions in your specialty's domain of practice.
- Refine the list by analysing research, gathering data, and asking for feedback from your society's membership.
- Finalise the list using pre-determined criteria and membership feedback to identify five low-value interventions that should be reduced in a given clinical context.
The EVOLVE process is rigorous and robust. All society members can take a role in developing the recommendations:
A Lead Fellow acts as the EVOLVE champion and is the primary point of contact with the RACP.
A Working Party of members drives the research and evidence review.
The wider specialty membership provides feedback throughout the development process and can be actively involved in determining the Top 5.
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