In the Franciscan program change team used evidence based practice by doing the following: Identifying a problem, the problem being that physicians and systems do not reliably address the needs of people approaching death. The team researched the evidence and found that unlike most other population management programs, that addressing the needs of people approaching death does not depend on laboratory values, medications, or strict service utilization algorithms to target individuals and Instead it relies on physician perceptions. When physicians were ask to refer patients that were gravely ill who would benefit from it supportive services the evidence showed that the request was to vague and to difficult to incorporate into practice and