NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim
With increasing healthcare demand, the healthcare system has been advancing drastically over the years, with the introduction of Evidence-based Practice (EBP) for the provision of safe and quality care. Several models such as the triple aim which has evolved to quadruple aim have also been established to promote population health with enhanced patients experience at a reduced cost (Bowles et al., 2018). Healthcare experts believe that the incorporation of EBP into current clinical practice will help reach the Quadruple Aim. As such, the purpose of the present paper is to discuss the quadruple aim and its role in evidence-based practice.
EBP and the Quadruple Aim on Patient Experience
The quadruple aim is focused on the creation of better care output among patients, at a reduced cost, with an improved experience for both the patient and the healthcare provider. With EBP, all the four measures of the quadruple aim can be achieved. For instance, utilization of EBP in the delivery of care and decision-making process on the most appropriate intervention promotes the experience of the patient, with improved care outcome (Haverfield et al., 2020). Patients tend to feel safe when clinicians utilize evidence-based treatment approaches when taking care of them.
EBP and the Quadruple Aim on Population Health
Concerning population health, EBP promotes the utilization of research in better understanding the characteristics, values, needs, and preferences of a certain population, which are key elements in care delivery. For instance, common chronic illnesses such as diabetes and cardiovascular conditions have posed great challenges over the years, with increasing morbidity and mortality rates (Wagner et al., 2018). However, EBP, through research has led to the introduction of novel approaches which are time efficient and easily accessible helping populations with the highest prevalence of these comorbidities hence promoting the achievement of the quadruple aim.
EBP and the Quadruple Aim on Healthcare Cost
Additionally, with the introduction of EBP, clinicians have reported improved prognosis of several health complications with has reduced hospitalization rate hence reduced healthcare costs. Consequently, the use of proven diagnostic tools and treatment approaches has led to a reduced treatment period, hence reducing the costs associated with diagnostic tests and medication (Haverfield et al., 2020). Clinicians have also been trained to utilize cost-effective care approaches and avoid unnecessary procedures to help reach the quadruple aim.
EBP and the Quadruple Aim on Work-Life of Healthcare Providers
Lastly, despite EBP promoting patient-centered care, the experience of the healthcare workforce has also been considered for optimal care benefits. As the fourth element of the quadruple aim, EBP has ensured that clinicians are adequately trained to utilize time-saving and effective medical tools, to improve the efficiency of the care process (Haverfield et al., 2020). The current healthcare system has introduced several interventions through EBP to decrease provider burnouts, stress, and depression which would otherwise lead to poor health outcomes and decreased patient satisfaction.
The healthcare system has evolved over the years towards the provision of safe and quality services. Currently, clinicians are encouraged to utilize EBP in care provision to improve the quality and efficiency of care provided at a reduced cost (Wagner et al., 2018). In the same line, the quadruple aim which evolved recently from the triple aim focuses on four main elements which can be achieved with the incorporation of EBP into current clinical practice.
The primary goal of the quadruple aim is to promote and improve higher-quality patient care experiences (Sikka, Morath, & Leape, 2015). EBP strategies can be used by clinicians and medical professionals to conduct research and then translate the findings into useful clinical roles. While evaluating study findings, use knowledge, methods for locating relevant content, and EBP concepts. As clinical nurses, we are always using the most up-to-date scientific information to provide care to our patients (Melnyk, 2018). This enables us to address the unique needs and challenges that each patient brings to treatment. EBP eventually allows nurses to provide better patient care in a variety of settings (Crabtree, Brennan, Davis, & Coyle, 2016). More importantly, EBP considers the patient’s preferences and values, allowing for the most successful patient care (Melnyk & Fineout-Overholt, 2018).
the health of the population
The Centers for Disease Control (CDC) and other major government agencies require EBP-tested solutions, particularly during the funding phase of population-based chronic disease prevention and control (Allen et al., 2018). This can lower illness load on populations while improving overall population health (Allen et al., 2018). Furthermore, the Quadruple Aim advocates for better patient outcomes and the promotion of higher-quality healthcare (Melnyk & Fineout-Overholt, 2018).
As a result of the use of evidence-based nurse retention methods, nursing leaders have been able to create policies and plans that will promote greater job satisfaction and, over time, boost the retention of newly hired nurses (Tang & Hudson, 2019). High nursing staff turnover can be expensive and has a detrimental influence on patient care’s safety and standard of care (Tang & Hudson, 2019). The quadruple aim can be achieved by using EBP to enhance clinician work satisfaction, cut needless spending, and improve patient care and results (Tang & Hudson, 2019).
hours of operation for healthcare professionals
Numerous studies have shown that nurses with EBP knowledge and training have more effective educational backgrounds and attitudes (Kim et al., 2016). A well-designed healthcare system is built on a quadruple goal, which is the cornerstone and beating heart of clinicals who are assured and empowered in their professions (Kim et al., 2016).
In conclusion, the quadruple goal is affected by the use of EBP in patient care, total population health and well-being, expenses, and clinical practices of a medical professional. The EBP principle promotes quality patient outcomes, gives clinicians and medical professionals more control, and helps build and create optimal patient care.
In this week’s assignment I will briefly describe and analyze the similarities and connection between Evidence-based practice (EBP) and the Quadruple Aim (QA). This paper is primarily focused on how EBP might (or might not) help reach the Quadruple Aim. It will each of the four measures of patient experience, population health, costs, and work-life of healthcare providers. Finally, the impact that EBP may have on factors affecting these quadruple aim elements, such as preventable errors in a clinical setting or nursing practice will also be considered.
Evidence-based practice is a method that assists clinical practitioners in determining the best course of action based on the values of their patients, relevant external research, and the clinician’s own experience. When it comes to the best principle that facilitates the patient’s experience with the capability of the clinician’s experience, and up-to-date knowledge, EBP is a good choice (Petra Dannapfel, 2015). It is implementing a problem-solving strategy in healthcare delivery that includes the most appropriate conclusions based on research that has been tested clinician expertise, medical practitioners, and patient preferences and outcomes (Melnyk, Fineout-Overholt, Stillwell, & Williamson, 2010).
The Quadruple aim combines the clinician’s experience, the patient’s experience, optimal outcomes, and the costs of the whole practice involved altogether. The quadruple aim focuses not only on the patients, health practitioners but also on the cost of the method. It enhances healthcare quality and patient outcomes, eliminates unnecessary costs, reduced costs, and empowered clinicians by the utilization of EBP (Melnyk & Fineout-Overholt, 2018).
Allen, P., Jacob, R., Lakshman, M., Best, L. A., Bass, K., & Brownson, R. C. (2018, Oct). Lessons learned in promoting evidence-based public health: Perspectives from managers in state public health departments. Journal of Community Health, 43(5), 856-863. http://dx.doi.org/10.1007/s10900-018-0494-0
Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172-175. http://dx.doi.org/10.1111/wvn.12126
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A., & Davidson, J. E. (2016, Oct). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340-348. http://dx.doi.org/10.1111/wvn.12171
Melnyk, B. M., & Fineout-Overholt, E. (2018). Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry. In B. M. Melnyk, Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed. (pp. 7-32). Philadelphia, PA: Wolters Kluwer.
Pannunzio, Valeria, Kleinsmann, Maaike. (2019). Design research, eHealth, and the convergence revolution. Retrieved from https://arxiv.org/ftp/arxiv/papers/1909/1909.08398.pdf
Petra Dannapfel. (2015). Evidence-Based Practice in Practice: Exploring Conditions forUsing Research in Physiotherapy. Retrieved from diva-portal.org/smash/get/diva2:862658/FULLTEXT01.pdf
- Mauricio Barría P. (2014). Implementing Evidence-Based Practice: A challenge for the nursing practice. Retrieved from scielo.org.co/pdf/iee/v32n2/v32n2a01.pdf
Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24(10), 608-610. http://dx.doi.org/10.1136/bmjqs-2015-004160
Tang, J. H., & Hudson, P. (2019, Nov). Evidence-based practice guideline: Nurse retention for nurse managers. Journal of Gerontological Nursing, 45(11), 11-19. http://dx.doi.org/10.3928/00989134-20191011-03
Evidence-Based Practice and Quadruple Aim
The performance of healthcare organization is often measured based on metrics such as costs of operation, quality of care, and improved patient experiences. The implication is that healthcare organizations are striving to ensure that these outcomes are met. They are in constant search of leadership as well as management models that will provide them with the competitive edge they desire in their markets. They also consider the use of quality improvement models as well as theories that would increase their productivity and performance. Over time, the increased focus on performance, productivity, safety, and efficiency have led to the rise of two models of healthcare practice that include evidence-based practice and the Quadruple Aim. Quadruple Aim and evidence-based practice focuses on improving healthcare outcomes by focusing on aspects that include patient experience, population health, costs, and work life of the healthcare providers. While these models of care promise to improve health outcomes, their role in underpinning each other’s success has not been explored. Therefore, this essay examines the manner in which evidence-based practice help reach Quadruple Aim.
Dang et al., (218) define evidence-based practice as the provision of healthcare based on the best available clinical evidence on the efficacy of the interventions used. It also entails taking into account the patients’ preferences and values, as well as the expertise of the healthcare providers, when determining the patients’ care needs. Increased use of evidence-based practice has been shown in studies to result in patient and provider satisfaction, improved quality and safety of care, and cost savings in healthcare. The Quadruple Aim is a model of care introduced by the Institute for Health Improvement to improve patient experiences, population health, healthcare costs, and healthcare providers’ work lives.
In many ways, evidence-based practice aids in the achievement of the Quadruple Aim. The practice focuses on providing care using the best available clinical evidence. Healthcare providers must conduct a critical review of the available evidence on meeting the health needs of diverse populations. The evaluation enables them to identify the best care approaches in terms of efficiency, quality, and safety (Yoder-Wise, 2019). It achieves patient outcomes such as access to safe, quality, and efficient care, thereby realizing the Quadruple Aim. Evidence-based practice is also concerned with lowering healthcare costs. Its application saves money in a variety of ways. First and foremost, healthcare providers prioritize patient safety and optimal recovery. Reduced hospital readmissions, unnecessary costs incurred due to adverse events, and shorter hospital stays all contribute to lower healthcare costs. Furthermore, EBP integrates healthcare providers’ experience, research, and patients’ values and preferences to drive optimum outcomes and best care in clinical settings (Garrett, 2018). Such outcomes include improved patient experiences, population health, care outcomes, and lower healthcare costs, resulting in the indirect realization of the Quadruple Aim.
There is also a correlation between the utilization of evidence-based practice with staff satisfaction. Evidence-based practice updates nursing practice, informs the use of efficient interventions in healthcare, and utilizes research to evaluate the work environment. Evidence-based practice encourages the use of modern methods of providing healthcare. The methods focus on the efficient use of the available resources. They also encourage the need for continuous development of the staffs, as a way of improving the care offered to those in need. There is also the evidence that it encourages staffs to engage in activities that promote the creation of safe working environment (Kang, 2016). Consequently, the wellbeing of the healthcare providers is enhanced due to safe working conditions, hence, the indirect realization of the Quadruple Aim.
In summary, evidence-based practice, helps improve the Quadruple Aim. It underpins the initiatives that should be adopted for the realization of the objectives of Quadruple Aim. Evidence-based practice focuses on improving healthcare metrics such as safety, quality, patient experiences, staff outcomes, and healthcare costs. These outcomes are also evident in Quadruple Aim. Therefore, as healthcare organizations focus on adopting evidence-based practice, the outcomes of Quadruple Aim will be met indirectly.
Dang, D., Dearholt, S., Sigma Theta Tau International., & Johns Hopkins University. (2018). Johns Hopkins nursing evidence-based practice: Model and guidelines. Indianapolis, IN : Sigma Theta Tau International.
Garrett, B. (2018). Empirical nursing: The art of evidence-based care. Bingley, UK: Emerald Publishing Limited.
Kang, H. (2016). Evidence-Based Practice and Job Satisfaction of Nurses in Long-Term Care. Open Journal of Nursing, 6(12), 977.
Yoder-Wise, P. S. (2019). Leading and Managing in Nursing. New York: Mosby.
NURS 6052/NURS5052/NRSE6052 Essent of Evidence
Week 2 Quiz
Question 1 What type of study is described in the following excerpt?
An interprofessional team wants to test a new intervention to see whether it will improve central-line associated bloodstream infection (CLABSI) rates. Subjects were randomized into either the intervention or the control group by pulling a slip of paper with either a one or a two written on it from a manila envelope (those pulling ones were randomized to the intervention group; those pulling twos were randomized to the control group). When the study began, the intervention group received the intervention and the control group received equal attention. Data was collected and analyzed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to report the data. NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim
Surveys to evaluate nurse satisfaction, medical errors, depression and anxiety, and demographics were given to 5,432 nurses from hospitals of various sizes and geographic locations; some had nurses working 8-hour shifts and 12-hour shifts. Nurses were asked to complete the survey. Upon completion of the survey, nurses were invited to participate in video conference focus groups and one-on-one interviews with a research assistant by video conferencing. Survey results were reported using descriptive statistics, and themes were identified and reported from the data collected in the focus groups and one-on-one interviews.
Question 9Which of the following statements is true of narrative reviews? (Select all that apply.)
Question 10In a systematic review with a meta-analysis, researchers combine the results of each of the individual studies to create a larger sample size (and therefore greater power), then re-run the statistics to capture the true magnitude of the effect. The single-effect measure calculated and reported when the results from all the studies are combined is called what?
Question 11In quantitative studies, results are reported using words or themes.
Question 12What types of information would help you identify a research study as quantitative? (Select all that apply.)
Question 13What kind of study is described in the following excerpt?
Question 14What type of literature may a systematic review include to be considered Level 1 evidence on the Melnyk & Fineout-Overholt levels of evidence hierarchy?
Question 15Randomized controlled trials are which type of research?
Question 16Order the following types of research evidence reviews in order of rigor from most rigorous to least rigorous:
Question 17When trying to determine what type of research study is described in an article, which two sections of the article will give you the best information to make that determination?
Question 18Both literature reviews and systematic reviews are types of research evidence reviews.
Question 19A key characteristic of a systematic review is that it contains a meta-analysis.
Question 20Which of the following types of research can be categorized as primary research? Select all that apply. NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim