FindingaConnectionBetweenEvidence-BasedPracticeandtheQuadrupleAim

NURS5052

FindingaConnectionBetweenEvidence-BasedPracticeandtheQuadrupleAim WaldenUniversity

NURS5052:EssentialsofEvidence-BasedPractice

FindingaConnectionBetweenEvidence-BasedPracticeandtheQuadrupleAim Evidence-basedpractice(EBP)hasbeenshowntobeeffectiveinimprovingpatient outcomessincethe1800sandFlorenceNightingale’sworkinmilitaryhospitalsduringthe CrimeanWar(Mackey&Bassendowski,2017).TheTripleAimdesignwasestablishedwith threegoalsinmindtoprovidehighqualitycare:improvinghealthcarequality,improvingpatient outcomes&reductionofhealthcarecost(Sikkaetal.2015).Ithasbeennotedtheadoptionofthe tripleaimisdependentuponengagedhealthprofessionalsleadingtoafourthgoal,improvingthe experienceofprovidingcareorsimplyempoweringclinicians(Sikkaetal.2015,Melnyk& Fineout-Overholt,2019)leadingtoachangeandtheformationoftheQuadrupleAim.EBPhasbeendefinedbytheconscientiousutilizationofthecurrentbestavailable evidencewhenmakingdecisionsforpatientcare(Melnyk&Fineout-Overholt,2019).Furthermore,thecomponentsofEBPutilizesthehealthprofessionalsownclinicalexpertise alongwithpatientvaluesandpreferencestoimproveoutcomes(Melnyk&Fineout-Overholt, 2019).ItisnotafarfetchedtobelievethattheuseofEBPcanhelporganizationsreachthe goaloftheQuadrupleAim.Thefirstfocusofthequadrupleaimistoimprovehealthcarequalityalsowhat somemaydescribeatthepatientexperience.Itisimportanttoprovidetheappropriatecarefor patientsdependentupontheirspecificcondition.Onewouldn’tgiveapatientwithaurinarytract infectionaprescriptionforaninhaledcorticosteroid.Sackettetal.(1996)(asfoundinMackey& Bassendowski(2017)recommended“cliniciansformulateadiagnosisbasedonevidenceand researchandthenincorporateindividualpatientpreference,values,andbeliefsintothatprocess.”

Thenextgoalwiththequadrupleaimistoimprovepatientoutcomes.Thisgoalis directlyrelatedtothefirstgoalofprovidingqualityhealthcare,aspatientsgivenproper evidence-basedtreatmenthavegreaterpositivehealthoutcomes.Italsoremainsimportantthat thetreatmentthatleadstothepositiveoutcomeisalsoreasonablyaccessibletowhomeveris administeringsaidtreatment.LargeUniversityhospitalshavemoreresourcesthantheirrural counterparts,despitebeingabletoestablishneworupdatedevidence-basedtreatments,inorder forthemtobecomestandardofcaretheyneedtobeaccessibletoallagencies.Reductionofcostinthesenseofthequadrupleaimisnotdecreasingfundingbut providingthebestevidence-basedtreatmentandinasensestreamliningthepatientscare.By usingEBPitcanleadtodecreasedhospitalstaysandcomplicationsrelatedtolonghospitalstays.Anotherexampleisthathospitalsarenotbeingreimbursedifpatientsdeveloppressureulcers whileadmitted,thishasleadresearchonbestpracticetopreventwounddevelopment.Thefinalpieceofthequadrupleaimisempoweringclinicians.Healthprofessionals reporthigherjobsatisfactionandfeelmoreempoweredwhenengaginginEBP(Melnyk& Fineout-Overholt,2019).Sikkaetal.(2015)notes,“Whilethefirstthreeaimsprovidearationale fortheexistenceofahealthsystem,thefourthaimbecomesafoundationalelementfortheother goalstoberealized.”Empoweringhealthcarestaffrequiresaneffectivehealthcareorganization thatpromotestheuseofEBP,withthebackbonebeinganengagedproductiveworkforce(Sikka etal.(2015).BarrierstoEBPincludelackofEBPknowledgeandskills,time,andorganizational culture(Melnyketal.2012asfoundinMelnyk&Fineout-Overholt,2019).Evidenceevolves regularlymakingitimportantforanorganizationtoencourageandpromotesuccessofthe quadrupleaimthusEBP.ThequadrupleaimreliesheavilyonEBP,asitshould.Supportiveorganizations whoputtime,effort,resources(money),intoeducatingandpromotingEBPaughtbeableto obtainthegoalslaidoutinthequadrupleaim.