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:
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:
By Day 7 of Week 1
Submit your analysis.
RUBRIC below:
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| Excellent | Good | Fair | Poor | ||
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Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of:
· Patient experience |
77 (77%) – 85 (85%)
The analysis clearly and accurately addresses in detail how evidence-based practice either supports or does not support the Quadruple Aim. The analysis accurately and thoroughly explains in detail how the four measures of patient experience, population health, costs, and work-life of healthcare providers either supports or does not support the Quadruple Aim. The analysis provides a complete, detailed, and specific synthesis of two outside resources reviewed on the four measures supporting or not supporting the Quadruple Aim. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the analysis provided with credible and detailed examples. |
68 (68%) – 76 (76%)
The analysis accurately addresses how evidence-based practice either supports or does not support the Quadruple Aim. The analysis accurately explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim. The analysis provides an accurate synthesis of at least one outside resource reviewed on the four measures supporting or not supporting the Quadruple Aim. The response integrates at least 1 outside resource and two or three course-specific resources that may support the analysis provided and may include some detailed examples. |
60 (60%) – 67 (67%)
The analysis inaccurately or vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim. The analysis inaccurately or vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim. The analysis provides an inaccurate or vague analysis of the four measures supporting or not supporting the Quadruple Aim with a vague or inaccurate analysis of outside resources. The response minimally integrates resources that may support the analysis provided and may include vague or inaccurate examples. |
0 (0%) – 59 (59%)
The analysis inaccurately and vaguely addresses how evidence-based practice either supports or does not support the Quadruple Aim or is missing. The analysis inaccurately and vaguely explains how the four measures of patient experience, population health, and work life of healthcare providers either supports or does not support the Quadruple Aim or is missing. The analysis provides a vague and inaccurate analysis of the four measures supporting or not supporting the Quadruple Aim with a vague and inaccurate analysis of outside resources. The response fails to integrate any resources to support the analysis provided or is missing. |
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Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. |
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive. |
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. |
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided. |
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Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation. |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. |
4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors. |
3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) grammar, spelling, and punctuation errors. |
0 (0%) – 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
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| Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. | 5 (5%) – 5 (5%)
Uses correct APA format with no errors. |
4 (4%) – 4 (4%)
Contains a few (one or two) APA format errors. |
3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) APA format errors. |
0 (0%) – 3 (3%)
Contains many (five or more) APA format errors. |
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| Total Points: 100 | |||||
Evidence-Based Practice and the Quadruple Aim
Evidence-based practice (EBP) involves use of the best available scientific evidence in clinical setting to formulate public policies and in nursing practice. Health professionals use EBP to solve problems and making healthcare decisions by integrating scientific studies, patient preference and values, clinician’s experiences and expertise (Morrow et al., 2018). EBP is used by organizations to ensure they provide high quality, safe, and efficient healthcare services.
To ensure success of EBP, it is recommended that an inter-professional model is adopted in decision making and implementation. Crabtree et al (2016) asserts that nurses have embraced a positive attitude towards EBP and are ready to obtain necessary skills set for implementation of EBP into clinical practice.
Quadruple aim is made up of four objectives including improvement of patient experience, population health, healthcare workers work-life, and lowering healthcare costs (Laskowski-Jones, 2016). These objectives accomplished through redesigning of healthcare facilities to lower healthcare costs and at the same time to improve population health through efficiency and effectiveness.
Batcheller et al (2017) asserted that to achieve success in implementation of EBP and meet objectives of the quadruple aim, it is necessary to have adequate and healthy workforce. Healthy workforce promoted transformation of triple aim to quadruple aim where a fourth goal (improvement of healthcare workers work-life) was incorporated.
Impact of EBP on Factors influencing Quadruple Aim Elements
Adoption of EBP is to improve healthcare quality and has an impact on work-life of healthcare providers. This is because healthcare providers need to be highly productive to offer healthcare services that are of good quality and safe. In addition, EBP patient experiences, population health and healthcare costs as discussed below.
Patient experience
Healthcare workers use EBP by translating the research findings into clinical practice based on individual patient needs (Kim et al., 2016). Successful development and implementation leads to improvement of quality of healthcare received by patients. With increasing adoption of EBP among healthcare organizations to solve clinical issues, patient care improves and in turn patient experiences.
Population health
EBP aims at educating population on cultural healthcare practices, personal health determinants, advantages, and disadvantages of particular treatments. According to Morrow et al (2018), integration of EBP in different populations aims at ensuring that resources ate distributed equitably to accomplish set aim.
When implementing EBP, populations are classified according to their needs which are identified using socio-economic status, health status, and family support. This is done to promote equitability in resource allocation. EPB processes are designed to address individual health needs and preferences.
Costs
Sikka et al (2016) asserted that healthcare facilities experience challenges in measuring of healthcare costs per capita. One major method organizations use to measure actual healthcare costs is through discounting and pricing. It is challenging to offer quality and safe healthcare services at lower costs. Therefore, organizations have embraced use of modern technologies to improve efficacy in healthcare services delivery and treatment methods as discovered through EBP. This has increased the quality and cost of healthcare services.
The Work-life of Healthcare Providers
A healthcare environment that is conducive supports inter-professional collaboration and teamwork. Empirical studies have shown that inter-professional collaboration improves patient health outcomes and leads to job satisfaction among healthcare providers (Batcheller et al., 2017).
In addition, it reduces fatigue, staff turn-over rates, and increases motivation at work which promotes staff productivity. A conducive work environment supports engagement of workforce in shared decision making and competitive remuneration. This promotes positive work-life among healthcare providers. In summary, it is necessary to examine the impact of EBP on factors influencing quadruple aim to make necessary adjustments.
References
Batcheller, J., Zimmermann, D., Pappas, S., & Adams, J. M. (2017). Nursing’s leadership role in addressing the quadruple aim. Nurse Leader, 15(3), 203-206.
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.
Laskowski-Jones, L. (2016). Finding joy and meaning in work: In support of the “Quadruple Aim”.
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.
Morrow, E., Call, M., Marcus, R., & Locke, A. (2018). Focus on the quadruple aim: development of a resiliency center to promote faculty and staff wellness initiatives. The Joint Commission Journal on Quality and Patient Safety, 44(5), 293-298.
Sikka, R., Morath, J. M., & Leape, L. (2015). The quadruple aim: care, health, cost and meaning in work.
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