EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM

To Prepare:

Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

Patient experience
Population health
Costs
Work life of healthcare providers

The connection between EBP and the Quadruple Aim

Evidence-based practice (EBP) involves the use of the best available evidence for decision-making and the provision of effective and efficient care for patients. According to Lavenberg, et al. (2019), EBP is widely acknowledged as integral to cost-effective, high-quality patient care. It is recommended that clinical decisions be based on evidence. This evidence-based patient care operationalizes the Triple Aim initiative, which established 3 overreaching goals for the delivery of health care; reducing the cost of care, improving the experience of the patient, and improving population health. Challenges in achieving the Triple Aim have consequently highlighted the necessity to support healthcare providers. Therefore, the Triple Aim has expanded to become the Quadruple Aim through the inclusion of a fourth goal of improving the work life of healthcare staff and providers EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM.

How EBP might help reach the Quadruple Aim, including each of the four measures:

Patient experience

Patient experience is an independent dimension of health-care quality and healthcare organizations are focusing on the way to enhance a superior patient experience. Bedside shift report, where the nurses give a report at the bedside in the presence of the patient or/ and family. an evidence-based strategy that can increase patient experience. According to Dorvil (2018), systematic literature reviews demonstrate that the implementation of nurse bedside shift reports has the potential to improve the experience of a patient with care as related to nurse communication. Nurse bedside shift report is improves patient experience by making patients informed about and involved in their care. Also, bedside shift report improves overall patient satisfaction as well as the patient-nurse relationship.

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Population health

EBP can improve population health through evidence-based public health (EBPH) practice. According to Allen et al. (2018), EBPH practice involves complex processes of improving population health and reducing disease burden. Examples of these processes are systematically using data on population risk factors and disease burden, intervention evidence and assessments of the community in making programmatic decisions and setting priorities; participatory decision-making; program planning frameworks; program evaluation, utilizing what is learned to enhance implementation; and disseminating what is learned. The Centers for Disease Control and Prevention along with other federal agencies required the utilization of evidence-based approaches when providing finances for the prevention of population-based chronic diseases and also requires control units in public health departments within states to support and fund local implementation of EBPH.

Costs

Healthcare-associated infections (HAIs) and inappropriate care are associated with a financial burden that affects healthcare institutions as well as patients. Interventions based on evidence-based practice can reduce the number of HAIs and inappropriate care and subsequently reduce healthcare costs. According to Lavenberg et al. (2019), health systems can create Evidence-based Practice Center (EPC) to support providers in integrating the best available evidence into decision-making so as to strengthen the safety and quality of care at the level of the individual patient and optimize the value of care delivered across the health system.

EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM – Work life of healthcare providers

An engaged and productive workforce is the backbone of an effective healthcare system However, the work environment which is characterized by time pressures, demanding work schedules, and emotional intensity can put healthcare providers at high risk of burnout. Organizations can reduce burnout and improve the work life of clinicians by improving the mental and physical health of providers. Aryankhesal et al. (2019), posit that recognition and burnout can play an influential role in improving the mental health of healthcare providers and therefore improving the quality of services they deliver. Communication skills training and psychiatric interventions and yoga are evidence-based interventions that prevent burnout in nurses and physicians. Psychiatric interventions such as meditation, yoga, and mindfulness interventions significantly increase self-care and significantly reduce burnout, emotional exhaustion, and exhaustion among nurses and physicians. EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM

References

Allen, P., Jacob, R. R., Lakshman, M., Best, L. A., Bass, K., & Brownson, R. C. (2018). Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments. Journal of Community Health, 43, 856-863. https://doi.org/10.1007/s10900-018-0494-0

Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Bahzadifar, M., Sohrabi, R. & Farhadi, Z. (2019). Interventions on reducing burnout in physicians and nurses: A systematic review. Medical Journal of the Islamic Republic of Iran, 33, 77. doi: 10.34171/mjiri.33.77 Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management, 49(6), 20-25. doi: 10.1097/01.NUMA.0000533770.12758.44

Lavenberg, J.G., Cacchione, P. Z., Jayakumar, K. L., Leas, B. F., Mitchell, M. D., Mull, N. K., & Umscheid, C. A. (2019). Impact of a Hospital Evidence-Based Practice Center (EPC) on Nursing policy and Practice. Worldviews on Evidence Based Nursing, 16(1), 4-11. doi: 10.1111/wvn.12346 EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM