Where in the World Is Evidence-Based Practice?

Healthcare Organization Website Review

Evidence-based practice is a tool used in healthcare to provide the most effective care that is available, intending to improve patient outcomes. It’s beneficial for problem-solving in the clinical care setting. EBP (evidence-based practice) is well-designed studies that have been done by clinical expertise. In reviewing EBP, I have discovered the healthcare organization Join

The reviewed website for this discussion belongs to New York-Presbyterian Hospital (Nyp.org, 2019). It is one of America’s largest and most comprehensive healthcare delivery system devoted to providing the highest quality and most comprehensive care and services to patients. Besides, it is a leader in medical education and the only academic medical center in the whole of the US affiliated with two world-class medical schools. As a leading healthcare organization, NewYork-Presbyterian (NYP) The hospital should be at the forefront in implementing Evidence-based practice (EBP). This has not been a letdown, as shown by its mission, vision, purpose, and QPS domains. In its mission, EBP is evident as the organization strives to be a high-quality hospital that facilitates quality, safety, and best patient outcomes (Nyp.org, 2019). NYP’s mission is aligned with the objectives of EBP, which is the promotion of high-value health care through the provision of quality and reliable care, improve health outcomes, and minimize differences in costs and care (Melnyk, Gallagher-Ford, Long & Fineout-Overholt, 2014).

EBP is shown in its vision, whose aim is to make NYP the best and safest academic health system through the promotion of zero harm, and a culture of safety, and reliability. In the purpose of the NYP, EBP is evident as the facility supports initiatives designed to develop and share best practices and attain optimal patient outcomes and family experience. Regarding QPS domains, EBP is evident in NYP quality improvement initiatives, patient safety, analytics, and infection prevention and control.

Grounding of EBP

An evaluation of the NYP website indicates that the organization’s work is grounded in EBP practice. The organization has formed partnerships with other healthcare organizations to provide the best medical education, patient-centered clinical care, and revolutionary research and innovation in the healthcare sector. According to Kowalski (2017), there are various ways to implement EBP in a hospital setting, and it includes education, peer involvement, leveraging expertise, promoting EBP culture, and many more. NYP achieves EBP when it creates and encourages EBP culture, EBP programs, research, innovations, and development of clinical guidelines in the clinical arena. For instance, it supports staff interested in EBP besides promoting a wide range of activities such as clinical trials to bring quality improvement (Crabtree, Brennan, Davis & Coyle, 2016). Supporting and involving healthcare providers in EBP is an important step taken by NYP because they serve as the front line of the clinical care and possess an exclusive chance to improve care via EBP.

Perception of Healthcare Organization

The information obtained on the website has changed my whole perception of hospitals and EBP. For instance, I have learned that hospitals are an integral component in enhancing EBP practices through the support of staff interested in EBP. Still, I have learned that EBP is part and parcel of the current health care system, which is now patient-centered.

 

References

Kowalski, M. (2017). Strategies to heighten EBP engagement. Nursing Management (Springhouse)48(2), 13-15. doi: 10.1097/01.numa.0000511928.43882.55

Melnyk, B., Gallagher-Ford, L., Long, L., & 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 Nursing11(1), 5-15. doi: 10.1111/wvn.12021

Nyp.org. (2019). NewYork–Presbyterian Hospital Medical center. Retrieved 24 November 2019, from https://www.nyp.org/about-us/patient-safety

Nyp.org. (2019). NewYork–Presbyterian Hospital Medical center. Retrieved 24 November 2019, from https://www.nyp.org/about-us/patient-safety

 

 

 

 

Evidence-based practice (EBP) is a lifelong analytic process to clinical practice that combines external evidence from research, evidence-based theories, clinical expertise, and patient preferences and values (Melnyk & Fineout-Overholt, 2018).  Best practice only occurs when staff continually ask questions about treatment and care, have the resources and skills necessary to search for and appraise research evidence, implement the evidence in practice, and evaluate its effectiveness (Dawes et al., [ 1] ; Hockenberry et al., [ 2] ).

After researching for a healthcare organization that has evidence-based practice, I found the “The American Geriatrics Society” (AGS).  AGS is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people (American Geriatric Society, 2020).  Founded in 1942, they have  6,000+ members which include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists who are pioneers in advanced-illness care for older individuals, with a focus on championing interprofessional teams, eliciting personal care goals, and treating older people as whole persons( American Geriatric Society, 2020).   In addition, AGS hosts the premier industry scientific event annually where professional from all geriatric disciplines can garner the most current information and information-based research regarding aging research, and new and creative research based clinical care and delivery plans. Their vision, “We are all able to contribute to our communities and maintain our health, safety, and independence as we age; and older people have access to high-quality, person-centered care informed by geriatrics principles.” (American Geriatric Society, 2020).

One AGS program, The AGS Annual Scientific Meeting, is the premier educational event in geriatrics, providing the latest information on clinical care, research on aging, and innovative models of care delivery (American Geriatric Society, 2020).  Held annually, the AGS Annual Scientific Meeting addresses the educational needs of geriatrics professionals from all disciplines.  Physicians, nurses, pharmacists, physician assistants, social workers, long-term care and managed care providers, health care administrators, and others can update their knowledge and skills through state-of-the-art educational sessions, including invited symposia, workshops, and meet-the-expert sessions (American Geriatric Society, 2020).

The American Geriatric Society is grounded in evidence-based practice in their programs.  One can find evidence of this on their home page website under the program tab.  One example is the Geriatrics Workforce Enhancement Program where they participate in fall prevention for the elderly.  On July 2, 2019, AGS wrote a letter to the Senate Special Committee regarding fall-related injuries and deaths, which are a major threat to the health and independence of older adults (American Geriatric Society, 2020).

As a nurse working with elderly patients, their family members and friends, my perception of AGS is that they are helpful in our society because the organization aims for something as unique as it is necessary like training the workforce we need.  This appears to be especially important because America has an extremely large and growing population of baby boomers.  Elderly people need and will continue to need a greater amount of care and comfort to lead a healthy life without worries and anxiety.

References

American Geriatric Society. (2020). Learn more about who we are. Retrieved from

https://www.americangeriatrics.org/about-us

Dawes, M., Summerskill, W., Glasziou, P., Cartabellotta, A., Martin, J., Hopayian, K., & … Osborne, J. (2005). Sicily statement on evidence ‐ based practice. BMC Medical Education, 5, 1. Retrieved from

https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=1&sid=1d908346-

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

 

 

According to Melnyk & Fineout-Overholt (2018), evidence-based (EBP) practice enhances the quality of healthcare and improves patient outcomes, so it is imperative that professional healthcare organizations use evidence-based practice.  The healthcare organization I chose to examine is the National Institute of Health (NIH).  The NIH is a governmental agency of the United States that is responsible for public health research.

The foundation of the NIH is based on evidence-based practice and this is evident from browsing their website.  An example of their use of EBP is found in the mission and goals statement in which they state that “NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of the knowledge to enhance health, lengthen life, and reduce illness and disability” (www.nih.gov, n.d.).  Melnyk & Fineout-Overholt (2018) discuss the six steps of the evidence-based practice process, and based off of this mission statement, we see the second step, searching for and collecting the most relevant best evidence, come into play.  To demonstrate the NIH’s dedication to the use of EBP, the Feinstein Institute for Medical research, the largest healthcare provider in New York, was awarded a grant from the NIH for $850,000 to support their efforts to create tools for doctors and advanced practice medical personnel to make and implement evidence-based clinical practice, as it is estimated that a third of hospital deaths are due to a lack of EBP practice (PRNewswire, 2019).

The NIH’s work is grounded in EBP as each step in the EBP process is seen throughout this healthcare organization.  The NIH begins with a question based off of a clinical situation.  They then receive funds to collect and search for the best and most relevant evidence.  The results of the studies are examined for validity and reliability.  They then integrate the evidence, evaluate the outcomes, and lastly disseminate the information.  On their website, there is a page dedicated to their 16 research initiatives and each appear to use the EBP process to further their research.

My perception of this healthcare organization has changed.  I knew what the NIH’s purpose was, but was surprised by the amount of funding and emphasis put on evidence-based practice to help practitioners implement these processes in their healthcare systems.  As Melnyk & Fineout-Overholt (2018) discuss, while there is research evidence to help dictate best practice but many healthcare systems are steeped in tradition, and unwilling to change their policies.  Mccormack (2017) makes the point that it is often difficult for healthcare workers to maintain compliance in their healthcare facility to ensure they are meeting the national standard for accreditation, but at the same time are encouraged to research EBP, although it might go against the standard of practice set in one’s workplace.  I was impressed that the NIH provides research for EBP but also encourages and supports figuring out how to actually implement new research into medical personnel’s practice.

References

Effort to “nudge” doctor’s adoption of evidence-based clinical practice receives NIH support. (2019). PRNewswire. Retrieved from https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=5&sid=0d897207-4e3e-4e11-a8a1-be03acbf85e1@pdc-v-sessmgr03&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ==#AN=201902131607PR.NEWS.USPR.CL53584&db=bwh

Mccormack, B. (2017). Compliance Versus Innovation in Evidence-Based Nursing. Worldviews on Evidence-Based Nursing, 14(3), 173–174. doi: 10.1111/wvn.12240

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

National Institutes of Health. (n.d.). Retrieved February 26, 2020, from https://www.nih.gov/

 

 

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.

 

The centers for Medicare & Medicaid services (CMS) is a government organization. Through this organization, many of our low-income families, pregnant women, people needing long term care and disabled individuals of all ages receive their access to proper health care. This is part of the department of Health and Human Services (HHS) which is used to provide benefits to these affected groups to ensure that medical care is provided whether it is for a routine doctor visit or hospital stay. As part of this agency, its mission to provide all Americans protection and provide essential human services (U.S. Department of Health and Human Services, 2017). Through this mission, it uses evidence-based findings to implement initiatives, provide information and address issues that affect the country.

One of the ways that they gather their information is through the collecting of data from providers that participate in Accountable Care Organizations (ACOs) that are a part of the Medicare Shared Savings Plan. They receive CAHPS scores from ACOs survey to determine the patient care as coordinated, quality care from the health care providers. The questions are core information used to assess the “specialist care, experience with care coordination, patient involvement in decision-making, experiences with a health care team, health promotion and patient education, patient functional status, and general health” (Centers for Medicare and Medicaid Services, 2018). The importance of the data is that it is stored as quality and financial data to compare care, cost and specialized procedures with health care providers to make informed health decisions.

To conclude, the collected information is important to identify trends in care and how to address them in a coordinated approach from health care professionals. This information that is collected and can be found on data.cms.gov, is information for research and implementing improvements that will benefit all American utilizing Medicare and Medicaid.

Reference

Centers for Medicare and Medicaid Services. (2018, October 22). CAHPS for ACOs. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/ACO

U.S. Department of Health and Human Services. (2017, February 10). HHS Historical Highlights. Retrieved from https://www.hhs.gov/about/historical-highlights/index.html

 

response

I enjoyed reading your discussion post.  It provides helpful information about how the Center for Medical and Medicare (CMS) gathers its information.  Another way in which CMS provides evidence-based practice (EBP) care to their patients is through research.  For example, in Bill and Smith (2016) explained that CMS was directed to create goals that help reduce the number of hospital-acquired pressure injuries (Beal & Smith, 2016).  As a result, hospitals now have developed methods such as turning patients every two hours and providing baths, to mention a few.

 Another way in which CMS has helped improve positive outcomes for hospitalized patients is through partnerships with other agencies such as the Center for Disease Control and Prevention.  One of the quadrupled aim’s objective is to improve patient outcomes.  To help with this, CMS has partnered with CDC in the past to provide evidence regarding CAUTI infection related to catheter use (Cantrell, 2016).  Thus, to ensure that patients receive the most effective and current care, CMS limits reimbursements related to CAUTI infections in the hospital. 

This decision forced hospitals to come up with CAUTI bundles to help prevent CAUTIs and improve patients’ outcomes.

Thank you for sharing this with us.

References

Beal, M. E., & Smith, K. (2016). Inpatient pressure ulcer prevalence in an acute care hospital using evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 112-117. http://dx.doi.org/10.1111/wvn.12145

Cantrell, S. (2016). CAUTI precaution. Healthcare Purchasing News, 40(1), 18-21. Retrieved from https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=7&sid=2ac2e86a-ef6d-4a8b-bf85-49852fe18cbe%40sessionmgr103

 

Based Evidence Practice plays a role when it comes to making decisions on promotion of good health or provision of care. The Implementation of EBP is important because it aims at giving patients the highest quality of care which leads to the best possible outcomes (Melnyk et al. 2018).

The organization of choice is the Center for Evidence and Practice Improvement (CEPI). It deals with creation of know-how, synthesis of evidence, translation of knowledge on what is functional in health care dissemination and advocates for improvement across the health scene. This organization plays the role of conducting and supporting research activities and evidence synthesis on delivery of health care, advances decisions and communication sciences so that patients can enjoy the luxury of informed treatment and decisions made on health care (Horn et al. 2010).

CEPI is made up of five constituent organizations, The Evidence Based Practice Center Program which is a source of evidence by review of information through the use of advanced methods so as to have impartial reviews, U.S. Preventive Service Task Force Program which avails technical data for the independent U,S Preventive Service Task Force empowering it to make recommendations which are grounded on evidence. The Division of Practice Improvement functions as a source of proof as well as method, means and analysis of practice enhancement while the Division of Health Information Technology comes up with policies of how health IT improves health care quality. The Division of Decision Science and Patient Engagement ensures informed decision making through the creation of tools and products based on findings which communicate and work in healthcare (Matchar et al 2013). From the roles played by its various divisions it is evident that CEPI is based on EBP and its role in the field of health care has made me appreciate what it stands for.

Reference.

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

Horn, S. D., Gassaway, J., Pentz, L., & James, R. (2010). Practice-based evidence for clinical practice improvement: an alternative study design for evidence-based medicine. Studies in health technology and informatics151, 446-460.

Matchar, D. B., & Samsa, G. P. (2013). The role of evidence reports in evidence-based medicine: a mechanism for linking scientific evidence and practice improvement. The Joint Commission journal on quality improvement25(10), 522-528.

internet Citation: Center for Evidence and Practice Improvement (CEPI). Content last reviewed January 2017. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/cpi/centers/cepi/index.html

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