NURS 6052 Assignment Evidence-Based Practice and the Quadruple Aim

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.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are 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.
  • 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
  • Note: You will access this article from the Walden Library databases.
  • 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

Evidence-Based Practice and the Quadruple Aim Example

The Quadruple Aim is a framework for augmenting or improving healthcare performance with efforts centered on enhanced population health, advanced experiences for healthcare providers, reduced healthcare costs, and better-quality patient experience. The achievement of the quadruple aim necessitates highly productive healthcare organizations with engaged and productive employees. EBP promotes quality care, improves patient outcomes, reduces healthcare costs, and increases employee morale, impacting the Quadruple Aim.

How EBP Might Impact the Quadruple Aim in Healthcare

There is a close connection between the Quadruple Aim and EBP: EBP influences the Quadruple Aim in healthcare. EBP results in advanced quality care, reduced costs, enhanced patient results, and increased nurse satisfaction (Mazurek et al., 2010). EBP impacts the Quadruple Aim measures: improving healthcare givers’ experiences, reducing costs, advancing population health, and improving the patient experience. EBP is a problem-solving method for healthcare provision. EBP incorporates superlative evidence from well-planned studies and patient care information, integrating it with nurse proficiency, patient values, and partialities (Mazurek et al., 2010). EBP promotes the Quadruple Aim measures by enhancing healthcare dependability and quality, reducing costs, and improving patient outcomes.

How EBP Might Help Reach the Quadruple Aim Measures

Patient Experience

EBP improves patient experiences by incorporating scientific evidence with patient values and partialities and a physician’s expertise. The scientific evidence encompasses internal evidence collected from patient information. EBP’s seven stages begin with cultivating an inquiry spirit where healthcare providers regularly ask clinical queries and search for scientific evidence (Melnyk et al., 2014). EBP leads to optimum clinical decisions that improve patient results and satisfaction, promoting a better-quality patient experience.

Population Health

The evidence-based practice seeks to offer the most operative and available care to enhance patient results. The EBP approach to population health has many direct and indirect advantages. The approach promotes entree to more and better-quality statistics and an increased propensity for operative prevention guidelines and programs (Mazurek et al., 2010). EBP also leads to improved employee performance and better use of private and public resources, impacting population health.

Healthcare Costs

Evidence-based practice alleviates healthcare costs by streamlining and standardizing care. Standardized treatment plans ensure that caregivers do not recommend inessential therapies or medications that might not help patients. EBP reduces the likelihood of unnecessary processes and medical errors that might incur extra costs. EBP provides the groundwork for obtaining necessary resources in clinical practice (Walewska-Zielecka et al., 2021). EBP decreases pointless medical processes, reducing healthcare costs.

Work-Life of Healthcare Providers

EBP improves healthcare providers’ experiences as it allows them to assess the research to comprehend the efficiency and risks of diagnostic treatments and tests. Work injuries are more common in healthcare than in other occupations (Sikka et al., 2015). Hours are wasted on occupational injury and disease in healthcare than in construction, mining, or machinery manufacturing (Sikka et al., 2015).

Implementing the EBP competencies as a device to develop and uphold the attainment of EBP familiarity, adopt a positive outlook towards EBP, and progress EBP skills to sponsor best practices improves healthcare providers’ experiences (Melnyk et al., 2014). EBP mentorship and culture are crucial variables that positively influence job gratification and will to stay among nurses (Melnyk et al., 2021). EBP simplifies clinical judgments and advanced quality care, improving the work life of healthcare providers.

Conclusion

Evidence-based practice impacts the Quadruple Aim (facilitating physician experiences, reducing costs, progressing population health, and improving the patient experience). EBP integrates scientific evidence with patient values, partialities, and a physician’s expertise, enhancing patient experiences. EBP also improves employee performance and population health and alleviates healthcare costs. Evidence-based practice provides the most effective, available care, boosts patient outcomes, decreases healthcare costs, and increases employee optimism, impacting the Quadruple Aim.

NURS 6052 Assignment Evidence-Based Practice and the Quadruple Aim References

Mazurek Melnyk, B., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). The Seven Steps of Evidence-Based Practice: Following this progressive, the sequential approach will lead to improved health care and patient outcomes. The American Journal Of Nursing, 110(1), 51-53.

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). Establishing evidence‐based practice competencies for registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5–15. 

Melnyk, B. M., Tan, A., Hsieh, A. P., & Gallagher‐Ford, L. (2021). Evidence‐based practice culture and mentorship predict EBP implementation, nurse job satisfaction, and intent to stay: support for the ARCC© Model. Worldviews on Evidence‐Based Nursing, 18(4), 272-281. https://doi.org/10.1111/wvn.12524

Sikka, R., Morath, J. M., & Leape, L. (2015). The quadruple aim: care, health, cost, and meaning in work. BMJ Quality & Safety, 24(10), 608–610. 

Walewska-Zielecka, B., Religioni, U., Soszyński, P., & Wojtkowski, K. (2021). Evidence-Based Care Reduces Unnecessary Medical Procedures and Healthcare Costs in the Outpatient Setting. Value in Health Regional Issues, 25, 23-28. 

NURS 6052 Assignment Evidence-Based Practice and the Quadruple Aim Rubric Detail

  Excellent Fair Poor
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

 77 (77%) – 85 (85%)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.
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.		 5 (5%) – 5 (5%)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.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.		 5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.
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. 5 (5%) – 5 (5%)Uses correct APA format with no errors.
Total Points: 100

NURS 6052 Assignment Evidence-Based Practice and the Quadruple Aim Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

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

  • Chapter 1, “Making the Case for Evidence-Based Practice and Cultivating a Spirit of Inquiry” (pp. 7–32)

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

Note: You will access this article from the Walden Library databases.

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.

Note: You will access this article from the Walden Library databases.

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.

Note: You will access this article from the Walden Library databases.

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53.

Note: You will access this article from the Walden Library databases.

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 costs. Worldviews on Evidence-Based Nursing, 11(1), 5–15.

Note: You will access this article from the Walden Library databases.

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

Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Required Media

Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file]. Baltimore, MD: Author.

Connection between EBP and Triple/Quadruple Aim Sample Paper

Patient outcomes have become a critical component in the transformation of healthcare. Triple/quadruple Aim is an excellent example of how healthcare organizations improve their services by turning to evidence-based practice-EBP. In the past, healthcare organizations concentrated their efforts on improving the health of populations, enhancing patient experience, and lowering the cost of healthcare. In recent years, the approach has added a critical component of improving the work-life of the staff of healthcare organizations.

The Triple Aim approach introduced in 2008 by Donald Berwick and his colleagues was a critical step in enhancing patient outcomes. However, the overarching goals by Berwick and the team ignored a critical component in providing enhanced and quality care to the patients, namely the work-life of healthcare workers (Fitzpatrick et al., 2019). The quadruple Aim has since enjoined this critical factor to the other three in the Triple Aim. The work-life of healthcare staff directly impacts the quality of care given to patients. Positive job satisfaction and cohesion lead to positive outcomes in patient care while job dissatisfaction by healthcare workers results in poor quality of service offered to patients/customers.

Sikka, Leape, and Morath (2015) identified job satisfaction as the fourth most critical goal in implementing evidence-based practice. The study by Sikka et al. (2015) revealed that EBP among healthcare practitioners is a primary predictor of job satisfaction. Transforming the healthcare sector and the provision of quality care to patients cannot happen until issues surrounding the work-life of healthcare workers are adequately addressed (p. 608).

Among the critical factors concerning the work-life of healthcare providers is job satisfaction. Indeed, a national survey done in the United States in 2017 revealed that over 1 million registered nurses nationwide quit their jobs because of stress and burnout (Kapu et al., 2019). The level of job satisfaction and motivation of the healthcare workers affect patient outcomes and the implementation of EBP.

Additionally, EBP enhances patient experience by focusing on such critical aspects as cost, quality of service delivered and ease of access to care. Patient experience is a critical parameter in the healthcare industry because it measures the level of satisfaction by patients with the services of healthcare providers. Patient experience is critical because it affects not just the health of patience, but also the profitability of healthcare organizations (Sikka, 2015).

Cost has been identified by health experts as one of the impediments to access to health. Many people in the country suffer silently because they cannot afford to pay for their healthcare. The Quadruple Aim introduces several measures that can be used by patients to afford healthcare. Excellent examples of methods of affordable care advocated for by this approach is a system of universal healthcare coverage for everyone through the affordable health insurance schemes.

Evidently, the Quadruple Aim seeks to enhance the quality of care given to patients by prioritizing the work-life of healthcare practitioners. The transformation of the healthcare sector cannot be implemented without taking care of the welfare and the work-life of healthcare workers. Attempts to implement the triple Aim have previously failed due to the omission of the improvement of the work-life of nursing practitioners. Quadruple Aim supports EBP because it addresses all critical factors necessary for the provision of quality healthcare, which includes taking care of the welfare of healthcare workers

NURS 6052 Assignment Evidence-Based Practice and the Quadruple Aim References

Fitzpatrick, B., Bloore, K., & Blake, N. (2019). Joy in Work and Reducing Nurse Burnout: From Triple Aim to Quadruple Aim. AACN Advanced Critical Care, 30(2), 185-188.

Kapu, A., Borg Card, E., Jackson, H., Kleinpell, R., Kendall, J., & Lupear, B. K., LeBar, K., Dietrich, M. S., Araya, W. A., Delle, J., Payne, K., Ford, J., & Dubree, M. (2019). Assessing and addressing practitioner burnout. Journal of the American Association of Nurse Practitioners, 33(1), 38-48.

Sikka, R., Morath, J., & Leape, L. (2015). The Quadruple Aim: care, health, cost and meaning in work. BMJ Quality & Safety, 24(10), 608-610.

Also read: NURS 6002 Transition to Graduate Study for Nursing