NURS 6052: Evidence Base Practice and the Quadruple Aim

NURS 6052: Evidence Base Practice and the Quadruple Aim

Evidence-based practice (EBP) involves making patient care decisions based on the best available scientific evidence and is widely accepted as the gold standard in practice (Kim et al., 2016). In parallel, the quadruple aim was introduced to enhance healthcare systems’ performance by addressing escalating healthcare costs, enhancing the patient care experience, and mitigating healthcare worker burnout (Arnetz et al., 2020). This paper explores how EBP can contribute to an organization’s achievement of the quadruple aim.

The Impact of EBP on Patient Experience

One of the central tenets of the quadruple aim is enhancing the patient experience. EBP is fundamental to improving patient outcomes and the quality of care (Kim et al., 2016). Enhanced care quality and patient outcomes invariably translate to an improved patient experience. A recent study exemplifies this relationship, where EBP strategies like hourly rounding, comprehensive bedside shift reports, and AIDET were consolidated into a nursing bundle to enhance emergency room care. This initiative resulted in a significant increase in positive patient experiences, with 60% of patients rating their overall experience as excellent, elevating the emergency room’s ranking to the 85th percentile (Skaggs et al., 2018). Thus, EBP implementation demonstrably improves the patient experience.

The Influence of EBP on Population Health

EBP empowers clinicians to effectively leverage research, promoting population health. The assimilation of research-based knowledge into clinical practice has significantly contributed to increased life expectancy over the last century (Lhachimi, 2016). Organizations such as the Centers for Disease Control and Prevention (CDC) provide accessible scientific research data along with implementation strategies to assist the population in disease prevention and treatment, thereby enhancing population health (CDC, 2021).

The Impact of EBP on Costs

EBP plays a pivotal role in reducing patient complications like healthcare-acquired infections and other health-related issues that result in poor patient outcomes, extended hospital stays, and increased healthcare costs. The implementation of EBP helps eliminate unnecessary medical procedures and costs, enabling healthcare organizations to achieve the quadruple aim. In one study, EBP recommendations led to a 31-37% reduction in adverse medical events and an 18% decrease in healthcare costs per patient, concurrently enhancing patient satisfaction (Walewska-Zielecka, 2021).

NURS-6052 Module 2: Quiz – IS IT QUANTITATIVE, QUALITATIVE, OR MIXED METHODS?

The Effects of EBP on the Work Life of Healthcare Providers

The incorporation of EBP within organizational settings not only leads to better patient outcomes and reduced hospital costs but also benefits healthcare providers by boosting job satisfaction (Kim et al., 2016). While implementing EBP may necessitate additional skill acquisition, it empowers clinicians, enhances job satisfaction, and mitigates burnout (American Association of Nurse Practitioners, 2021).

Conclusion

EBP serves as a linchpin for achieving the quadruple aim within healthcare organizations. It bolsters care quality and safety, improves health outcomes, reduces unnecessary healthcare costs for patients, and augments job satisfaction among healthcare teams. EBP is an indispensable element for realizing 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., van Schagen, 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

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 is impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.