NURS6052 Walden University Evidence-Based Practice & Quadruple Aim
This analysis will determine the relationship between evidence-based practice and the Quadruple Aim, as well as how evidence-based practice improves the patient experience, population health, cost, and the well-being of healthcare workers.
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Melnyk and Fineout-Overholt (2019) define evidence-based practice (EBP) as using the best, most current evidence when making patient care decisions. Over the years, evidence-based practice has evolved; it now incorporates clinical appraisal, clinical expertise or external wisdom, and patient values and preferences into clinical practice and problem-solving across the lifespan. The Institute for Healthcare Improvement launched the Triple Aim initiative in 2008 to ensure that healthcare is delivered more safely and effectively. Dr Thomas Bodenheimer coined “Quadruple Aim” in a 2014 paper published in The Annals of Family Medicine. Kay (2018) stated that to achieve the Triple Aim objectives, a fourth goal, the well-being of the healthcare worker, must be included. Much research supports and proves that evidence-based practice successfully enhances the Quadruple Aim when used effectively.
Despite progress toward meeting the Quadruple Aim’s outcome goals, much work remains. Patients continue to report receiving poor care from disgruntled and frustrated healthcare workers. This directly results from the healthcare worker’s disengagement for various reasons. The evidence-based practice identifies several methods for engaging healthcare employees at work. Organizations must provide safer workplaces without physical and psychological harm (Sikka et al., 2015). According to Boller (2017), EBP has demonstrated that care coordination models effectively improve population health. This concept entails the collaboration of all members of a patient’s healthcare team, most notably the patient themselves. Finally, when organizations use EBP to deliver healthcare, healthcare costs are reduced significantly. Cost savings may be realized by avoiding complications that result in additional patient care costs that are not reimbursed, reducing the length of stay in some cases, and encouraging better self-management following discharge, resulting in the use of fewer healthcare services (Tucker, 2014).
Evidence-based practice has shown that care coordination models effectively improve population health. Clinicians collaborate with all members of the patient’s healthcare team, including the patient. There are several barriers to EBP implementation, including a lack of knowledge and skill when applying EBP, a lack of experienced mentors to support the implementation, and, last but not least, an organizational culture unwilling to support EBP (Valdez, 2018). Leaders must understand that EBP is the direct path to achieving the Quadruple Aim in healthcare; they must be willing to invest in it knowing that healthcare quality and safety will improve, population health outcomes will improve, healthcare costs will decrease, and clinician job satisfaction will increase as EBP spreads throughout the organization (Melnyk & Raderstorf, 2019).
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References
Melnyk, B.M., Fineout-Overholt, E. (2019). Evidenced-based practice in nursing and healthcare (4th ed.). Wolters Kluwer.
Kay, J. (2018). The Quadruple aim: From understanding to action. American College of Cardiology. https://www.acc.org/membership/sections-and- councils/fellows-in-training-section/section- updates/2018/11/20/08/11/the-quadruple-aim
Sikka, R., Morath, J., & Leape, L. (2015). The quadruple Aim: care, health, cost, and Meaning in work. British Medical Journal, 24(10), 608. https://www- ProQuest-com.ezp.waldenulibrary.org/docview/ 1778837907?accountid=14872
Boller, J. (2017). Nurse educators: Leading healthcare to the Quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707–708. https://www-proquest- com.ezp.waldenulibrary.org/docview/1972281107?accountid=14872
Tucker, S. (2014). Determining the return on investment for evidence-based practice: An essential skill for all clinicians. Worldviews on Evidence-Based Nursing. https://sigmapubs.onlinelibrary.wiley.com/doi/ full/10.1111/wvn.12055
Valdez, A. (2018). What guides your practice? Journal of Emergency Nursing, 44(1), 1–4. https://www.jenonline.org/article/S0099-1767(17)30608-6/pdf
Melnyk, B.M., & Raderstorf, T. (2019). Evidence-based leadership, innovation, and entrepreneurship in nursing healthcare. Springer Publishing. https://doi.org/10.1891/9780826196255
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Question 
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.
NURS6052 Walden University Evidence-Based Practice & Quadruple Aim
More recently, this approach has evolved to a Quadruple Aim by focusing on improving healthcare providers’ work life. 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.
To Prepare:
Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
Consider EBP’s impact on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.
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:
Patient experience
Population health
Costs
Work-life of healthcare providers