Evidence-based Research and Quality of Care
Evidence-based Research and Quality of Care
Quality healthcare can be defined as the extent to which health services for both individuals and population can increase the possibility of desired health outcomes consistent with the professional knowledge and practice. When all the available evidence is used and applied in the evaluation of various options before reaching a decision in clinical management and practice and policy making. This can be termed as evidence-based medicine (Sultz&Young, 2011). The use of academic research in formulation of polices and improvement of quality of care is important because the evidence provided by research is vital for accountability purposes. For instance, practices that have been found to improve the health status and quality of care and life for those participating then there is no reason why such evidence should support and lead to change in policy and how we care for the patients.
According to Spatz et al (2012) people who are insured or under insured have a great challenge as far as accessing health screening, preventive and specialty care is concerned. Their only hope is to depend on the national health care safety net system. The patients who have no insurance or underinsured have to depend on community health centers to get specialized care but these centers are themselves overwhelmed because of the many clients they are required to serve and they also have fewer specialists physicians attending to vulnerable population and in turn this has caused; overwhelming of emergency services and hospitals, fragmented health care plans, disease advancement and long wait times for patients before they can see a doctor.
These problems however have been taken care of by project Access, implemented in New Haven to overcome challenges to access of specialty care by the help of researchers, health care providers and advocates. This project is aimed at creating a network of hospitals and specialists willing to provide free or donate care to both uninsured and underinsured patients by integrating this care through patient navigation. The fundamental aim of the project is to have a patient-centered approach that is characterized by scheduling of medical appointments, negotiating language and literacy barrier, access to free or discounted medication that have been prescribed and connecting with health-related resources. In addition under this approach patient navigators are empower patients to be more proactive to participate in primary care and engage with specialty care. The results have been, improved or quality care for patients in terms of timely access to specialty care, satisfaction for both patients and physicians and finally reduction in number of visits to emergency department (Spatz et al,.2012) .
Another example of evidence-based research and how it has contributed to quality care is the partnership between the University of California-Los Angeles and the Los Angeles emergency medical service agency (Grudzen et al, .2012).This collaboration led to development and changes as it relates to cardiopulmonary resuscitation of patients. This collaboration was created against a background of a research that had been done and found that the EMS agency was carrying out resuscitation on all patients regardless of the personal preference of the concerned patient, how the resuscitation might help them and the challenges and physical harm associated with the process.
The community-patterned research approach comprised of community members, health experts and practice group, the Los Angeles emergency medical service agency to come up with guidelines to decrease harmful and unnecessary and potentially harmful cardiopulmonary resuscitation attempts. Because of this research all six perquisites and standards related to do no attempt resuscitation (DNAR) were include in the practice guidelines. This has improved the quality of care given to patients in emergency situations and thus greatly benefiting them in return by reduction of exposure to unnecessary and harmful resuscitation.
According to Jadad (2000) the internet can be great tool in generation, synthesis, dissemination and exchange of health research .The internet is providing unprecendetn opportunities to access information by health care professionals that can help in making that affect them and their clients by using evidence-based research.
A good example is the Cochrane collaboration that people to make informed decisions about their health by making sure that there is access to up-to-date reviews and analyses about the potential risks and benefits of health care interventions professional organizations and governments have also been involved in the use of the internet to facilitate dissemination and access to evidence based clinical guidelines. For instance, National Guideline Clearinghouse that offers access to evidence-based clinical practice guidelines form various organizations in North America. This enhances quality care by providing evidence-based clinical care for patients according to their circumstances. Doctors or healthy specialists can find out what other doctors have written and research available to help them improve the quality of care for patients.
There are some branches of health that are still resistant to change and utilization of evidence based research in proving health care such as pediatric nursing.Persisence of myths, bias ,tradition in pain management of pain in infants and children has greatly limited the application of research based practices. However, there is a shift with hospitals putting much more emphasis on patient safety and prioritizing making sure that the hospitals are safe for patients and especially children. This together with other measures that support evidence-based practices in the delivery of quality care (Hughes, 2008).
In conclusion, to ensure that patients are getting the best care there is need to incorporate evidence based research and not be stuck in the past and the old way of doing things as far quality care is concerned.
Grudzen, C., L. D. Richardson, W. J. Koenig, J. R. Hoffman, K. A. Lorenz, and S. M.
Asch. 2012.Translation of Evidence-Based Clinical Standards into a New Prehospital
Reususcitation Policy in Los Angeles County.” Health Services Research
47 (1, part II): 363–373.
Hughes, R. (2008). Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services.
Jadad, A. (2000). The Internet and evidence-based decision-making: A needed synergy for efficient knowledge management in health care. J Med Internet Res Journal of Medical Internet Research.
Spatz, E. S., M. S. Phipps, O. J. Wang, G. I. Lucas, S. Lagarde, L. A. Curry, and M. S.
Rosenthal. 2012. Expanding the Safety net of Specialty Care for the Uninsured:
A Case Study.Health Services Research 47 (1, part II): 344–362.
Sultz, H. A., & Young, K. M. (2011). Health care USA: Understanding its organization and delivery (7th ed.). Sudbury, MA: Jones & Bartlett Learning. ISBN-13: 978-0-7637-8458-4; ISBN-10: 0-7637-8458-3.
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