Evidence-Based Practice and The Quadruple Aim

Healthcare organizations are focused on improving patient experiences, reducing the costs of care, ensuring optimal population health, and improving the work life of healthcare providers with the goal of achieving the Quadruple Aim. Evidence-based practice (EBP) provides a structured framework for making decisions that can help reach the Quadruple Aim: Evidence-Based Practice and The Quadruple Aim.

Evidence-based practice helps deliver patient-centered care as it considers patients’ perspectives in decisions made in the design of care plans (Engle et al., 2021). Furthermore, integrating EBP into the decision-making process evidently leads to improved quality of patient care, better patient safety, and better clinical outcomes (Connor et al., 2023). At the same time, patient safety practices within healthcare and patient care settings led to improved patient experiences, including satisfaction with the care (Alabdaly et al., 2024).

EBP is also critical in achieving population health as a measure of the Quadruple Aim as it focuses on combining the best available evidence with provider knowledge and expertise, as well as the unique patient and population health needs. Such a combination is then translated into practice and used to guide healthcare practices that result in an improved population. As EBP involves utilizing actual population health data and analysis and evaluation of the outcomes of past healthcare practices and strategies, it can help create new practices and practices that can help effectively address population-level health challenges, including social, mental, and physical health issues and challenges. Hence, EBP has the potential to improve overall population health outcomes.

Further analysis of the literature consistently links the integration of EBP in health settings to improving the costs of care and the work life of healthcare providers. The quality of care is significantly associated with the overall burden of disease and the associated costs of care. Low quality of care is associated with an increased risk of multimorbidity (Soley-Bori et al., 2020) and longer length of stay due to healthcare-associated infections (Manoukian et al., 2021), which have all been linked to increased burden on health systems and increased costs of care (Manoukian et al., 2021; Soley-Bori et al., 2020).

EBP is a basic framework for providing quality care (Ratish, 2019), which can optimize quality and efficiency within healthcare settings, leading to reduced costs of care. Additionally, using evidence-based systems such as EHRs has been associated with improved clinical workflow, decision-making, and overall health system performance (Rodrigues et al., 2020). Efficient workflow and decision-making reduce workload and other factors that increase the risk of burnout, such as stress among healthcare providers, especially nurses. Hence, EBP within healthcare settings can lead to increased satisfaction with work and reduced work-related pressure.

However, the issues of resistance to change in practice among healthcare providers, lack of organizational-level readiness for EBP implementation, and a lack of provider competencies for EBP are major barriers to EBP in healthcare settings (McNett et al., 2022). Such barriers to EBP might be a drawback to using EBP to help reach the Quadruple Aim.

Regardless of these barriers, EBP is a critical framework that, if correctly integrated into the decision-making process, can help health organizations to improve the level of quality and safety of patient care, patient experiences within healthcare settings, efficiency in care delivery leading to reduced costs, and better population, while at the same striking a work-life balance for health providers. Therefore, it is essential for health organizations to leverage EBP to achieve the Quadruple Aim.

References

Alabdaly, A., Hinchcliff, R., Debono, D., & Hor, S. Y. (2024). Relationship between patient safety culture and patient experience in hospital settings: A scoping review. BMC Health Services Research, 24(1), 1–10. https://doi.org/10.1186/S12913-024-11329-W/TABLES/4

Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, P. F., Hole, A., Moore, L., Brown, R., Melnyk, B. M., & Gallagher-Ford, L. (2023). Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6–15. https://doi.org/10.1111/WVN.12621

Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based practice and patient-centered care: Doing both well. Health Care Management Review, 46(3), 174–184. https://doi.org/10.1097/HMR.0000000000000254

Manoukian, S., Stewart, S., Graves, N., Mason, H., Robertson, C., Kennedy, S., Pan, J., Kavanagh, K., Haahr, L., Adil, M., Dancer, S. J., Cook, B., & Reilly, J. (2021). Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK. Journal of Hospital Infection, 114, 43–50. https://doi.org/10.1016/J.JHIN.2020.12.027

McNett, M., Tucker, S., Zadvinskis, I., Tolles, D., Thomas, B., Gorsuch, P., & Gallagher-Ford, L. (2022). A qualitative force field analysis of facilitators and barriers to evidence-based practice in healthcare using an implementation framework. Global Implementation Research and Applications 2022 2:3, 2(3), 195–208. https://doi.org/10.1007/S43477-022-00051-6

Ratish, S. (2019). Evidence-based practice-A key to quality patient care. International Journal of Nursing Education and Research, 7(4), 638. https://doi.org/10.5958/2454-2660.2019.00144.3

Rodrigues, A. L., Torres, F. B. G., Gomes, D. C., Carvalho, D. R., Santos, E. A. P., & Cubas, M. R. (2020). Workflow and decision making of operating room nurses: Integrative review. Revista Gaúcha de Enfermagem, 41, e20190387. https://doi.org/10.1590/1983-1447.2020.20190387

Soley-Bori, M., Ashworth, M., Bisquera, A., Dodhia, H., Lynch, R., Wang, Y., & Fox-Rushby, J. (2020). Impact of multimorbidity on healthcare costs and utilisation: A systematic review of the UK literature. The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 71(702), E39–E46. https://doi.org/10.3399/BJGP20X713897

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