EVIDENCE-BASED PRACTICE AND THE QUADRUPLE AIM

Evidence Based Practice and the Quadruple Aim

NURS 6052: Essential of Evidence Base Practice

Evidence-based practice requires making patient care decisions based on the best available scientific evidence and is widely accepted as the best standard in practice. Adopting and implementing EBP in nursing and other healthcare practices is crucial to improving the quality of care and patient outcomes (Kim et al., 2016). Another model known as the quadruple aim was established to improve the performance of healthcare systems by combating the rising cost of healthcare, improving the patient care experience, and reducing burnout among healthcare workers (Arnetz et al., 2020). This paper addresses how EBP may help an organization reach the quadruple aim.

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The Effects of EBP on Patient Experience

One of the foci of the quadruple aim is to improve the patient experience. Evidence-based practice is essential to improving patient outcomes and quality of care (Kim et al.,2016). Improved quality of care and patient outcome leads to improved patient experience. In a recent study, evidence-based strategies such as hourly rounding, bedside shift report including updates of test results and events, and AIDET were implemented as a nursing bundle as part of a quality improvement initiative. The nursing bundle led to an increase in positive patient experiences in the emergency room. Following the implementation of the nursing bundle, 60% of patients rated their overall experience as excellent, propelling the emergency room’s ranking to the 85th percentile. (Skaggs et al., 2018). Implementation of EBP leads to improved patient experience.

The Effects of EBP on Population Health

Evidence-based practice allows clinicians to utilize research more effectively, promoting population health. Much notable knowledge has been gained from research over the last century and implementing this knowledge in clinical practice has increased life expectancy (Lhachimi, 2016). Organizations like the Centers for Disease Control and Prevention (CDC) provide scientific research data which are easily accessible with implementation strategies to help the population with the prevention and treatment of disease to improve population health (CDC, 2021).

The Effects of EBP on Costs

Evidence-based practice reduces patient complications such as healthcare-acquired infections and other health issues, leading to poor patient outcomes, increased hospital stay, and healthcare costs. Implementing EBP helps eliminate unnecessary medical procedures and costs, allowing health organizations to achieve the quadruple aim. In a study, evidence-based practice recommendations led to a 31-37% decrease in adverse medical events and an 18% reduction in healthcare cost per patient while improving patient satisfaction (Walewska-Zielecka,2021).

The Effects of EBP on the Work Life of Healthcare Providers

Utilization of EBP in an organization setting not only leads to better patient outcomes and decreased hospital costs. Improved patient outcomes also benefit healthcare providers by promoting increased job satisfaction (Kim et al., 2016). Although implementing EBP may require some additional skillset, it empowers clinicians, improves job satisfaction, and decreases burnout (American Association of Nurse Practitioners, 2021).

Conclusion

 EBP is key to achieving the quadruple aim in a healthcare organization. EBP leads to enhanced quality of care and safety, improved health outcomes, eliminates unnecessary health costs for patients, and can improve job satisfaction for the healthcare team. EBP is an essential ingredient needed to achieve 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 Evidence Based Practice and the Quadruple Aim

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

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

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.

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.
• Evidence Based Practice and the Quadruple Aim

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
• Evidence Based Practice and the Quadruple Aim