Evidence-informed person-centred practice: an integrative framework for evidence use in healthcare

Integrating evidence into clinical care has become a defining feature of modern healthcare. Longstanding evidence-based approaches, including evidence-based medicine, evidence-based practice, and evidence-informed practice have strengthened expectations that healthcare professionals will locate, interpret, and apply research evidence in everyday decision-making. Yet persistent tensions remain. Limited and inconsistent patient involvement, challenges in sustaining the skills needed to enact evidence use, the hierarchical privileging of empirical research over other meaningful forms of knowledge, and the influence of contextual and systemic constraints continue to impede its practical uptake. Together, these conceptual and operational limitations highlight the value of an integrative framework that more fully reflects the complexities and realities of contemporary care. Guided by principles of a critical review, we examined foundational and contemporary literature on evidence-based approaches and related concepts (e.g. context, reflective practice, implementation). We reviewed influential texts and supplemented them with targeted searches to identify constructs underrepresented in the initial sources. The framework was then developed and refined through the combined expertise and positionality of the research team and a co-production process with leaders from a national professional association. We propose the Evidence-Informed Person-Centred Practice (EIPP) framework, which integrates and extends existing approaches to evidence use by making explicit the dynamic, collaborative, and context-responsive nature of evidence use. EIPP comprises four enactment processes: research awareness, shared decision-making, reflective practice, and implementation, each supported by distinct forms of critical thinking. These processes are shaped by three outer domains: systemic contextual conditions, professional accountability, and collective readiness. Together, these components support the delivery of individualized, appropriate care: the right care, by the right provider, for the right patient, in the right setting, and at the right time. Beyond proximal outcomes, EIPP aims to contribute to broader goals of health and well-being, health equity, provider experience, and system efficiency, aligning with the Quintuple Aim. EIPP offers an integrative synthesis of existing approaches to evidence use by making explicit the interdependence of knowledge, context, partnerships, and action. The framework brings together multiple knowledge sources, collaborative decision-making, reflective practice, and implementation, while positioning the use of evidence as a shared responsibility shaped by professional and systemic conditions. Future research should examine the feasibility, usability, and impact of EIPP across diverse care settings and determine how it may need to be adapted across professional, organizational, cultural, and health system contexts.