Posted: September 3rd, 2023

The Connection Between Evidence-Based Practice and the Quadruple Aim

Assignment: The Connection Between Evidence-Based Practice and the Quadruple Aim

RESOURCES

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.
Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–36
Boller, J. (2017). Nurse educators: Leading health care to the quadruple aim sweet spot.Links to an external site. 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 practiceLinks to an external site.. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participantsLinks to an external site.. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171
Melnyk, B.M., Fineout-Overhold, E., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: The seven steps of evidence-based practiceLinks to an external site.. American Journal of Nursing, 110(1), 51-53.
Melnyk, B. M., Gallagher-Ford, L., Long, L. E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costsLinks to an external site.. Worldviews on Evidence-Based Nursing, 11(1), 5–15. doi:10.1111/wvn.12021
Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost and meaning in workLinks to an external site.. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160
Walden University Library. (n.d.-a).Databases A-Z: NursingLinks to an external site.. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981
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 the impact that EBP may have 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 of:

Patient experience
Population health
Costs
Work life of healthcare providers
Assignment_Rubric

Criteria

Write a brief analysis of the connection between evidence-based practice and the Quadruple Aim. Your analysis should address how evidence-based practice might (or might not) help reach the Quadruple Aim, including each of the four measures of: Patient experience Population health Costs Work life of healthcare providers

Ans.
The Quadruple Aim framework proposes improving patient experience of care, improving population health outcomes, reducing per capita healthcare costs, and enhancing clinician well-being and work life satisfaction as key goals for healthcare systems (Bodenheimer & Sinsky, 2014). A growing body of evidence-based research explores the degree to which various care delivery and payment models impact progress on these four dimensions.
Patient experience encompasses factors like access to care, care coordination and communication, which evidence shows can be improved through patient-centered medical home (PCMH) models (Reid et al., 2010). Systematic reviews find PCMHs associated with better patient and provider reported experiences (Jackson et al., 2013). However, some studies note limited impact on experience measures from PCMHs alone without additional supports (Nutting et al., 2011).
Population health aims to improve whole populations’ physical and mental wellness. Evidence demonstrates care management programs for chronic conditions can lower costs from preventable hospitalizations and emergency visits (Peikes et al., 2009). Community health workers also show promise in managing social determinants impacting health, though more rigorous research is still needed (Kangovi et al., 2017).
Controlling costs is a key driver behind value-based payment models. Studies comparing fee-for-service to alternative payment models find some models may modestly reduce total costs through lower utilization (Colla et al., 2016). However, cost savings vary significantly by model and more research on long-term cost impacts is warranted (McWilliams et al., 2016).
Work-life factors for clinicians encompass burnout, workload, and job satisfaction. Evidence links burnout to quality of care and avoidable medical errors (Shanafelt et al., 2019). PCMHs show mixed results on provider experience, with some studies finding benefits and others no impact (Bodenheimer & Sinsky, 2014). Team-based care models show promise in workload distribution but require cultural shifts (Brandt et al., 2014).
In summary, while evidence-based research provides some support for the Quadruple Aim framework, the degree of impact varies across its four dimensions and by specific care delivery and payment models. Ongoing rigorous evaluation is still needed, particularly around long-term population health and cost outcomes. A multidisciplinary, system-wide approach may be required to fully achieve the Quadruple Aim’s ambitious goals.
Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: care of the patient requires care of the provider. Annals of family medicine, 12(6), 573–576. https://doi.org/10.1370/afm.1713
Brandt, B. F., Lutfiyya, M. N., King, J. A., & Chioreso, C. (2014). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. Journal of interprofessional care, 28(5), 393–399. https://doi.org/10.3109/13561820.2014.906391
Colla, C. H., Lewis, V. A., Shortell, S. M., & Fisher, E. S. (2016). First National Survey of ACOs Finds That Physicians Are Playing Strong Leadership and Ownership Roles. Health Affairs, 35(6), 987–993. https://doi.org/10.1377/hlthaff.2015.1488
Jackson, G. L., Powers, B. J., Chatterjee, R., Bettger, J. P., Kemper, A. R., Hasselblad, V., Dolor, R. J., Irvine, J. M., Heidenfelder, B. L., Kendrick, A. S., Gray, R., & Williams, J. W. (2013). The patient-centered medical home: a systematic review. Annals of internal medicine, 158(3), 169–178. https://doi.org/10.7326/0003-4819-158-3-201302050-00579
Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., Shannon, R. P., & Long, J. A. (2017). Community Health Worker Support for Disadvantaged Patients May Be Cost-Effective. Health Affairs, 36(2), 245–253. https://doi.org/10.1377/hlthaff.2016.0848
McWilliams, J. M., Hatfield, L. A., Chernew, M. E., Landon, B. E., & Schwartz, A. L. (2016). Early Performance of Accountable Care Organizations in Medicare. The New England journal of medicine, 374(24), 2357–2366. https://doi.org/10.1056/NEJMsa1600142
Nutting, P. A., Crabtree, B. F., Miller, W. L., Stange, K. C., Stewart, E., & Jaén, C. (2011). Transforming physician practices to patient-centered medical homes: lessons from the national demonstration project. Health Affairs (Project Hope), 30(3), 439–445. https://doi.org/10.1377/hlthaff.2010.0159
Peikes, D., Chen, A., Schore, J., & Brown, R. (2009). Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. JAMA, 301(6), 603–618. https://doi.org/10.1001/jama.2009.126
Reid, R. J., Fishman, P. A., Yu, O., Ross, T. R., Tufano, J. T., Soman, M. P., & Larson, E. B. (2009). Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. The American journal of managed care, 15(9), e71–e87.
Shanafelt, T. D., Hasan, O., Dyrbye, L. N., Sinsky, C., Satele, D., Sloan, J., & West, C. P. (2015). Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clinic proceedings, 90(12), 1600–1613. https://doi.org/10.1016/j.mayocp.2015.08.023
The analysis clearly and accurately addresses in detail how evidence-based practice either supports or does not support the Quadruple Aim. … The analysis accurately and thoroughly explains in detail how the four measures of patient experience, population health, costs, and work-life of healthcare providers either supports or does not support the Quadruple Aim. … The analysis provides a complete, detailed, and specific synthesis of two outside resources reviewed on the four measures supporting or not supporting the Quadruple Aim. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the analysis provided with credible and detailed examples.

Criteria

Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

Ans.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. … A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

Criteria

Written Expression and Formatting—English Writing Standards:Correct grammar, mechanics, and proper punctuation.

Ans.

Uses correct grammar, spelling, and punctuation with no errors.

Criteria

Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

Ans.

Uses correct APA format with no errors.

_____________________________________
Sample Answer:
The Connection Between Evidence-Based Practice and the Quadruple Aim
In the healthcare industry, the Quadruple Aim has emerged as a framework for improving healthcare delivery and outcomes. The Quadruple Aim consists of four interconnected goals: enhancing patient experience, improving population health, reducing costs, and improving the work life of healthcare providers (Sikka, Morath, & Leape, 2015). Evidence-based practice (EBP) plays a crucial role in achieving these goals by ensuring that healthcare decisions and interventions are based on the best available evidence. This analysis will explore the connection between EBP and the Quadruple Aim, examining how EBP can support each of the four measures.
Patient Experience
Enhancing patient experience is a key component of the Quadruple Aim. EBP can significantly contribute to improving patient experience by promoting the delivery of high-quality, patient-centered care. By integrating the best available evidence into clinical decision-making, healthcare providers can ensure that their practices align with patient preferences and values. For example, EBP can guide the implementation of interventions that have been proven effective in improving patient satisfaction, such as bedside rounding or shared decision-making (Crabtree, Brennan, Davis, & Coyle, 2016). By incorporating patient preferences and values into care decisions, EBP can enhance patient experience and promote patient-centered care.
Population Health
Improving population health is another crucial aspect of the Quadruple Aim. EBP plays a vital role in achieving this goal by guiding the implementation of evidence-based interventions and preventive measures. By utilizing the best available evidence, healthcare providers can identify effective strategies for preventing and managing diseases, reducing healthcare disparities, and promoting health promotion and disease prevention initiatives. For example, EBP can inform the development and implementation of population-based interventions, such as vaccination campaigns or community health programs, that have been proven effective in improving population health outcomes (Kim et al., 2016). By integrating EBP into population health initiatives, healthcare providers can make informed decisions that have a positive impact on the health of communities and populations.
Costs
Reducing healthcare costs is a significant challenge faced by healthcare systems worldwide. EBP can contribute to cost reduction by promoting the use of interventions and practices that have been proven to be cost-effective. By utilizing evidence-based guidelines and protocols, healthcare providers can avoid unnecessary tests, treatments, and procedures that may be costly but offer little or no benefit to patients. EBP can also guide the implementation of interventions that have been shown to reduce healthcare utilization and costs, such as care coordination programs or telehealth services (Sikka et al., 2015). By incorporating cost-effectiveness considerations into clinical decision-making, EBP can help healthcare systems achieve the goal of reducing costs while maintaining high-quality care.
Work Life of Healthcare Providers
Improving the work life of healthcare providers is a crucial aspect of the Quadruple Aim. EBP can contribute to this goal by promoting a culture of continuous learning and professional development. By integrating EBP into clinical practice, healthcare providers can stay updated with the latest evidence and best practices, which can enhance their knowledge and skills. This, in turn, can lead to increased job satisfaction, professional growth, and a sense of empowerment among healthcare providers (Boller, 2017). EBP can also help reduce the burden of decision-making by providing healthcare providers with evidence-based guidelines and protocols that can guide their practice. By supporting healthcare providers in delivering high-quality care based on the best available evidence, EBP can contribute to improving their work life and overall job satisfaction.
Conclusion
Evidence-based practice plays a crucial role in achieving the goals of the Quadruple Aim in healthcare. By integrating the best available evidence into clinical decision-making, EBP can enhance patient experience, improve population health, reduce costs, and improve the work life of healthcare providers. By promoting the use of evidence-based interventions and practices, healthcare systems can strive towards achieving the Quadruple Aim and ultimately improve the overall quality and outcomes of healthcare delivery.
References
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
Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A.-M., & Davidson, J. E. (2016). Predictors of evidence-based practice implementation, job satisfaction, and group cohesion among regional fellowship program participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. doi:10.1111/wvn.12171
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

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