Question

Why is healthcare research, commonly referred to as evidence-based medicine (EBM), important to healthcare leaders? Give a specific example of a contemporary EBM or research discovery and tell us how it positively impacts various stakeholders (e.g., patients, providers, third-party payers, managers and leaders, legislators, etc.).

Answer 1

Answer:

Evidence-based practice (EBP) is defined by Duke University Medical Center as the integration of clinical expertise, patient values and the best research evidence into the decision-making process for patient care. EBP is the secret sauce to enable us to get to that quadruple aim.”

EBP strategies allow NPs and other health care providers to translate research findings into clinical practice. With efficient literature-searching skills and the application of formal rules of evidence in evaluating research findings, providers can apply existing scientific knowledge in their clinical practice for each individual patient.

“The Institute for Healthcare Improvement said we should target the triple aim in health care: improving the patient experience, improving population health outcomes and decreasing health care costs,” says Melnyk. “Some years after the triple aim goal came out, a fourth aim was added: improving the work life of clinicians and their well-being. EBP is the secret sauce to enable us to get to that quadruple aim.”

In a time when NPs and many other providers experience symptoms of burn out, EBP can be empowering. While it may require a different skillset, research has shown that when providers deliver evidence-based care, patient outcomes are markedly improved.

Unfortunately, even when health care providers hold positive opinions about EBP, many do not actively implement EBP strategies due to a lack of time, lack of leadership buy-in and investment or lack of understanding.

Example of EBP:

For example, an “individual” perspective of EBP would leave the decision about use of evidence-based endotracheal suctioning techniques to each nurse and respiratory therapist. Some individuals may be familiar with the research findings for endotracheal suctioning while others may not.

This is likely to result in different and conflicting practices being used as people change shifts every 8 to 12 hours. From an organizational perspective, endotracheal suctioning policies and procedures based on research are written, the evidence-based information is integrated into the clinical information systems, and adoption of these practices by nurses and other practitioners is systematically promoted in the organization. This includes assuring that practitioners have the necessary knowledge, skills, and equipment to carry out the evidence-based endotracheal suctioning practice. The organizational governance supports use of these practices through various councils and committees such as the Practice Committee, Staff Education Committee, and interdisciplinary EBP work groups.

The Translation Research Model,35built on Rogers’s seminal work on diffusion of innovations,39 provides a guiding framework for testing and selecting strategies to promote adoption of EBPs. According to the Translation Research Model, adoption of innovations such as EBPs are influenced by the nature of the innovation (e.g., the type and strength of evidence, the clinical topic) and the manner in which it is communicated (disseminated) to members (nurses) of a social system (organization, nursing profession).35Strategies for promoting adoption of EBPs must address these four areas (nature of the EBP topic; users of the evidence; communication; social system) within a context of participative change.

This model provided the framework for a multisite study that tested the effectiveness of a multifaceted TRIP intervention designed to promote adoption of evidence-based acute pain management practices for hospitalized older adults. The intervention improved the quality of acute pain management practices and reduced costs.81 The model is currently being used to test the effectiveness of a multifaceted TRIP intervention to promote evidence-based cancer pain management of older adults in home hospice settings.

This guiding framework is used herein to overview what is known about implementation interventions to promote use of EBPs in health care systems

So the major impact is that without an EBP we cannot perform any procedure in the right sense. It has greater hidden impact on the patient care, outcome of the patient and so on.