NURS 6052 Assignment EBP and the Quadruple Aim

NURS 6052 Assignment EBP and the Quadruple Aim

Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

Assignment: Evidence-Based Practice and the Quadruple Aim SAMPLE

Introduction:

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 helps clinical practitioners to select the best course of action according to patients’ values, useful external research, and the clinician’s own experience. The EBP is a good choice when it comes to the best principle the facilitates the patient’s experience with the capability of the clinician’s experience, and up-to-date knowledge (Petra Dannapfel, 2015). It is applying a problem-solving strategy to the delivery of healthcare which included the most appropriate conclusions based off research that have 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).

Patient experience

The main objective goal of the quadruple aim is foster and develop improved quality care experience for the patient (Sikka, Morath, & Leape, 2015). Medical Practitioners and clinicians are able to incorporate EBP strategies into their research studies and eventually interpret the conclusions deduced into practical clinical roles. By making use of knowledgeable skills and strategies, literature-searching methods, and the implementation of EBP’s concepts in the evaluation of research findings. As nurses in a clinical setting we are constantly using existing scientific knowledge as we render care to our patients (Melnyk, 2018). By so doing we are able to address the various needs and problems each and every individual present for treatment. Eventually with EBP, nurses maintain improved patient care in their various practices respectively (Crabtree, Brennan, Davis, & Coyle, 2016). More importantly, with the concept of EBP, the patient’s preference and values are greatly considered which allows for ultimate patient care satisfaction (Melnyk & Fineout-Overholt, 2018).

Population health

The Centers for Disease Control (CDC) as well as other major federal agencies require approaches that have been tested by EBP, especially during the funding phase of population-based chronic disease prevention and control (Allen et al., 2018). This can foster overall improved health on the populace while eradicating disease burden in populations (Allen et al., 2018). Some other components of the Quadruple Aim include developing better and more effective patient outcomes and fostering improved quality healthcare (Melnyk & Fineout-Overholt, 2018).

Costs

Evidence-based practices on the nurse retention have helped to create guidelines and strategies for nursing leaders to foster increased job satisfaction which in turn leads to an increase in the retention of newly hired nurses’ overtime (Tang & Hudson, 2019). Experiencing a high turnover in nursing staff can be quite expensive and costly, which negatively impacts the safety and quality of care provided to patients (Tang & Hudson, 2019). EBP can be used to enhance job satisfaction amongst clinicians, it decreases unnecessary costs, establishes improved patient care and outcomes, which are all components of the quadruple aim (Tang & Hudson, 2019).

Work-life of healthcare providers

Extensive research studies reveal that nurses that have training and knowledge d in EBP have more efficient educational backgrounds and attitudes (Kim et al., 2016). Clinicals that have a sense of confidence and empowerment in their practices factor into a quadruple aim in healthcare, which is the foundation and core of a well-structured healthcare system (Kim et al., 2016).

In summary, the implementation of EBP in in patient care, overall health and well-being of a population, costs and clinical practices of a medical practitioner collectively factor into the quadruple aim. The principle of EBP helps to develop and create optimum patient care, without unnecessary cost, fwhile fostering quality patient outcomes, and empowering medical practitioners and clinicians.

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

By Day 7 of Week 1

Submit your anaylsis.

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Next Module

 Module 1: Evidence-Based Practice and the Quadruple Aim (Week 1)

Laureate Education (Producer). (2018). Evidence-based Practice and the Quadruple Aim [Video file]. Baltimore, MD: Author.

Learning Objectives

Students will:

• Evaluate healthcare organizations for evidence-based practices
• Analyze the relationship between evidence-based practice and the Quadruple Aim in healthcare organizations

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–32)

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

Note: You will access this article from the Walden Library databases.

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. doi:10.1111/wvn.12126

Note: You will access this article from the Walden Library databases.

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). 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. doi:10.1111/wvn.12171

Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53. doi:10.1097/01.NAJ.0000366056.06605.d2

Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5–15. doi:10.1111/wvn.12021

Note: You will access this article from the Walden Library databases.

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file]. Baltimore, MD: Author.

Discussion: Where in the World Is Evidence-Based Practice?

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

In this Discussion, you will consider this adoption. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

• Review the Resources and reflect on the definition and goal of EBP.
• Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
• Explore the website to determine where and to what extent EBP is evident.

By Day 3 of Week 1

Post a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days by visiting the websites they shared and offering additional examples of EBP or alternative views/interpretations to those shared in your colleagues’ posts.

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Evidence-Based Practice and the Quadruple Aim

With the current healthcare system striving towards achieving patient safety and improving the quality of care provided, evidence-based practice has provided a leeway for this to be possible (Gallagher‐Ford et al., 2020). Consequently, with the utilization of numerous models like the triple aim which has advanced to the quadruple aim in promoting population health, hospitals have been trying to advance patient experience while still reducing the associated care costs. Healthcare experts speculate that with the application of EBP, the future healthcare system will be able to achieve the Quadruple Aim. The purpose of this discussion is to illustrate how EBP can help achieve the Quadruple Aim.

Patient Experience

            The main focus of the quadruple aim is to promote a better patient care output, at an affordable cost, with improved patient experience and that of the healthcare provider. With the appropriate implementation of EBP, all the four quadruple aim measures can be attained. For starters, EBP promotes the use of interventions that have already been proven to be effective in meeting the healthcare needs of the patient (Bowles et al., 2018). As such, the healthcare provider will ensure that only the most effective evidence-based interventions are utilized, promoting care output. Consequently, patients normally build confidence in choosing a given treatment plan, when there is proof of success, hence EBP will help in promoting their experience.

Population Health

Through EBP, clinicians have been able to conduct research that promotes an in-depth understanding of a population’s characteristics, needs, preferences, and values which are crucial in promoting patient-centered care. It thus becomes easier to prioritize their needs or healthcare issues and come up with the most effective intervention to promote their health. For instance, diabetes type 1 is more prevalent among white children in the United States as compared to any other race/ethnicity (Wagner et al., 2018). Through EBP, the use of insulin pump therapy has helped in promoting glycemic control and preventing comorbidities among this population.

Healthcare Cost

EBP has been reported to promote the safety and quality of care provided, hence reducing the recovery time and improving the prognosis of several chronic conditions. With an improved prognosis, patients tend to spend less time in the hospital as they are used to reducing the associated costs of prolonged hospitalization (Gallagher‐Ford et al., 2020). Healthcare professionals have also been trained to utilize cost-effective care approaches and try as much as possible to avoid unnecessary procedures to help reduce the cost of care and reach the quadruple aim.

Work-Life of Healthcare Providers

Healthcare professionals play a significant role in promoting the safety and quality of care provided. As such, investing in their welfare to improve their work-life experience is very crucial. With EBP, healthcare organizations have been able to find the most effective strategy to promote a good work-life balance for the healthcare providers such as improving their professionalism through training and use of current technology like EHR which is time-saving among others (Haverfield et al., 2020). Additionally, several EBP interventions have been implemented in the current healthcare system to help decrease provider burnout, stress, and depression promoting their work experience.

Conclusion

            The current healthcare system has been revolutionized with EBP promoting patient care outcomes. Healthcare organizations have been able to achieve the quadruple aim by implementing EBP in improving the patient experience at a reduced care cost as demonstrated in the discussion above.

References

Bowles, J. R., Adams, J. M., Batcheller, J., Zimmermann, D., & Pappas, S. (2018). The role of the nurse leader in advancing the Quadruple Aim. Nurse Leader, 16(4), 244-248.

Gallagher‐Ford, L., Koshy Thomas, B., Connor, L., Sinnott, L. T., & Melnyk, B. M. (2020). The effects of an intensive evidence‐based practice educational and skills-building program on EBP competency and attributes. Worldviews on Evidence‐Based Nursing, 17(1), 71-81.

Haverfield, M. C., Tierney, A., Schwartz, R., Bass, M. B., Brown-Johnson, C., Zionts, D. L., … & Zulman, D. M. (2020). Can Patient-Provider Interpersonal Interventions Achieve the Quadruple Aim of Healthcare? A Systematic Review. Journal of general internal medicine, 1-11. https://doi.org/10.1007/s11606-019-05525-2

Wagner, E. H., LeRoy, L., Schaefer, J., Bailit, M., Coleman, K., Zhan, C., & Meyers, D. (2018). How do innovative primary care practices achieve the quadruple aim?. The Journal of ambulatory care management, 41(4), 288-297. DOI: 10.1097/JAC.0000000000000249