Evidence-Based Practice and the Quadruple Aim

Evidence Based Practices and Quadruple Aim

NURS-6052A Walden University

Evidence Based Practices and Quadruple Aim

Evidence-based practices (EBP) has become a global term that stands for delivering high quality care to improve patient outcomes (Melnyk and Fineout-Overholt, 2018). The definition of evidence-based practice (EBP) is the employment of current best evidence to make decisions about patient care (Spyder, 2018). The surge in increased use of EBP can be found in the shift from reimbursement to patient care supported with the passing of the Affordable Care Act (Laureate Education (Producer), 2018). The critical elements of EBP are clinical expertise, current best evidence and patient perspective. The EBP process relies on scientific exploration and IT assistance in recognizing the question and solving the question to which improvements and guidelines are needed.

At the same time the Quadruple Aim was developed to improve care. The elements of quadruple aim are the patient experience, population health, reduction of costs, and care team for well-being. The surge for the need for focusing on these areas of nursing is the alarming number of preventable deaths from medical errors (Boller, 2017). There were approximately 100,000 preventable deaths in hospitals each year. Therefore, IOM called for improvements in patient care, interprofessional collaboration and quality improvements and the use of informatics. Sikka, Morath, and Leape (2015) points out that the framework for the Quadruple Aim was created in 2008 with the intention that the Quadruple Aim would redesign the healthcare system and the view of population health. The goal was to improve health and reduce healthcare cost. This new method of viewing care through the aims categorizing.

How EBP and Quadruple Aim work together. The Quadruple Aim focuses on best practices. The patient experience will only improve with better quality care and safety. This only occurs if one reduces medical errors and implements the quality care, improve patient centered care, improve population health, reduces costs and improves the work environment for health workers. The evidence-based practices identify the problem to which needs to be solved. After identification of the problem, one will review alternatives through research. Once all alternatives are found, they are evaluated to determine the best practice to solving the problem. The new guidelines are put into place. Lastly, the evidence-based practice is evaluated to determine if the solution to the problem was valid. Therefore, the two go hand in hand in addressing problems within the healthcare industry.

In summary, patient experience can only be improved through a better health care environment that is patient centered, culturally competent, offers quality care and safety. There is risk to the patient when the environment of care is harmful and full of bullying, has poor design of workflow and the employees do not feel valued. In addition, the patient must be treated with dignity and respect in every encounter (Crabtree, Brennan, Davis, & Coyle, 2016). The staff working with the patient must be educated and trained. The second aim is population health. If the staff working with patient is not finding joy or understand the different populations and health problems, they will not provide quality care (Crabtree, Brennan, Davis, & Coyle, 2016). The third aim is costs. If there is not access to health or healthcare is too expensive, there will not be quality of care (Crabtree, Brennan, Davis, & Coyle, 2016). Lastly, one must find the best practice for work environment for health care providers (Crabtree, Brennan, Davis, & Coyle, 2016). If the best practice for the quality of work life balance, respect and education is not provided there will not be quality of care. The evidence-based practices will determine the best methods of addressing all of the aims of the Quadruple Aim problems.

Reference

Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. doi:10.3928/01484834-20171120-01

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. doi:10.1111/wvn.12126

Laureate Education (Producer). (2018). Evidence-based Practice and the Quadruple Aim [Video file]. Baltimore, MD: Author.

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

Spyder. (2018, July 27). Evidence-Based Practice. Retrieved from https://www.amsn.org/practice-resources/evidence-based-practice.

Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160.