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:
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Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.
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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
- Evidence-based practice and the quadruple aim
Evidence-based practice and the quadruple aim
The concept of evidence-based practice (EBP) entails making healthcare decisions based on the most reliable scientific evidence available and is widely acknowledged as the gold standard in healthcare. The adoption and integration of EBP in nursing and other healthcare domains play a pivotal role in enhancing the quality of care and patient outcomes (Kim et al., 2016). Additionally, another framework called the quadruple aim was formulated to enhance the performance of healthcare systems by addressing the escalating healthcare costs, enhancing the patient care experience, and mitigating burnout among healthcare professionals (Arnetz et al., 2020). This article explores how EBP can facilitate an organization in attaining the quadruple aim.
Impact of EBP on Patient Satisfaction
One of the core objectives of the quadruple aim is to enhance the overall patient experience. Evidence-based practice plays a crucial role in elevating patient outcomes and the quality of care (Kim et al., 2016). Improved care quality and patient outcomes are directly linked to an enhanced patient experience. In a recent study, evidence-based strategies, such as regular check-ins, bedside shift reports with timely updates on test results and events, and the use of AIDET, were incorporated as part of a quality enhancement initiative in the emergency room. This nursing bundle contributed to a rise in positive patient experiences, with 60% of patients rating their overall experience as excellent, consequently elevating the emergency room’s ranking to the 85th percentile (Skaggs et al., 2018). The implementation of EBP leads to an improved patient experience.
Impact of EBP on Public Health
Evidence-based practice empowers healthcare professionals to harness research more effectively, thereby advancing public health. Over the last century, substantial knowledge has been amassed through research, and implementing this knowledge in clinical practice has contributed to increased life expectancy (Lhachimi, 2016). Organizations such as the Centers for Disease Control and Prevention (CDC) offer readily accessible scientific research data, coupled with implementation strategies, to aid the public in disease prevention and treatment, thus enhancing population health (CDC, 2021). Evidence-based practice aligns with the goals of the quadruple aim.
Impact of EBP on Cost Reduction
EBP plays a pivotal role in reducing patient complications like healthcare-acquired infections and other health issues that can lead to adverse patient outcomes, prolonged hospital stays, and increased healthcare expenses. The adoption of EBP helps in curtailing unnecessary medical procedures and associated costs, enabling healthcare organizations to realize the objectives of the quadruple aim. In a study, recommendations based on evidence-based practice resulted in a 31-37% decrease in adverse medical events and an 18% reduction in healthcare costs per patient, all while enhancing patient satisfaction (Walewska-Zielecka, 2021).
Impact of EBP on the Well-being of Healthcare Professionals
The integration of EBP in organizational settings not only yields better patient outcomes and reduced hospital costs but also benefits healthcare providers by fostering increased job satisfaction (Kim et al., 2016). While implementing EBP may necessitate some additional skill development, it empowers clinicians, enhances job satisfaction, and mitigates burnout (American Association of Nurse Practitioners, 2021).
In Conclusion
EBP stands as a cornerstone in achieving the quadruple aim within healthcare organizations. It contributes to improved care quality, safety, better health outcomes, reduced unnecessary healthcare expenses for patients, and has the potential to enhance job satisfaction among the healthcare team. EBP is an indispensable element for realizing the goals of the quadruple aim (Melnyk & Gallagher-Ford, 2019).
References
American Association of Nurse Practitioners. (2021, April 1). Why choose evidence-based practice? Retrieved December 4, 2022, from https://www.aanp.org/news-feed/why-choose-evidence-based-practice
Arnetz, B. B., Goetz, C. M., Arnetz, J. E., Sudan, S., vanSchagen, J., Piersma, K., & Reyelts, F. (2020). Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study. BMC research notes, 13(1), 362. https://doi.org/10.1186/s13104-020-05199-8
Centers for Disease Control and Prevention. (2021, July 13). Division of Population Health at a glance. Retrieved December 4, 2022, from https://www.cdc.gov/chronicdisease/resources/publications/aag/population-health.htm
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A., & 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. https://doi.org/10.1111/wvn.12171
Lhachimi, S. K., Bala, M. M., & Vanagas, G. (2016). Evidence-Based Public Health. BioMed research international, 2016, 5681409. https://doi.org/10.1155/2016/5681409
Melnyk, B. M., & Gallagher-Ford, L. (2019). Achieving the quadruple aim in healthcare with evidence-based practice: A necessary leadership strategy for improving quality, safety, patient outcomes, and cost reductions. Evidence-Based Leadership, Innovation, and Entrepreneurship in Nursing and Healthcare. https://doi.org/10.1891/9780826196255.0008 Evidence-based practice and the quadruple aim
Skaggs, M. K. D., Daniels, J. F., Hodge, A. J., & DeCamp, V. L. (2018). Using the Evidence-Based Practice Service Nursing Bundle to Increase Patient Satisfaction. Journal of emergency nursing, 44(1), 37–45. https://doi.org/10.1016/j.jen.2017.10.011
Walewska-Zielecka, B., Religioni, U., Soszyński, P., & Wojtkowski, K. (2021). Evidence-Based Care Reduces Unnecessary Medical Procedures and Healthcare Costs in the Outpatient Setting. Value in health regional issues, 25, 23–28. https://doi.org/10.1016/j.vhri.2020.07.577 Evidence-based practice and the quadruple aim
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