It enables medical professionals to make better informed decisions about patient care. There are six steps in the basic EBP process:
- Assess the patient
- Ask a focused clinical question
- Acquire evidence to answer the question
- Appraise the quality of the evidence
- Apply the evidence to the patient’s care
- Evaluate the patient’s outcome and the practitioner’s performance.
Going back to Florence Nightingale, and right through the current day, proponents of evidence-based practice have tried to enhance it. There is even a Center for Evidence and Practice Improvement, with a division specifically focused on EBP. Let’s take a look at why EBP often does not produce the desired results — and the opportunity for hospitals and health systems to further advance the influence of EBP on patient care.
Why does EBP fall short?
There’s no question that insufficient training contributes to reduced EBP success. While practitioners, particularly nurses, are trained in the evidence-based practice process, that training is often disconnected from actual EBP implementation. The training may be very good, but EBP is difficult to support when evidential resources are here, there, and everywhere. To successfully learn and practice EBP, students and other stakeholders must be highly organized, and propel themselves to find a mentor to answer their questions. While many organizations offer EBP training, busy practitioners don’t have the bandwidth to find and actually do it.
What else keeps evidence-based practice from reaching its potential? The process itself can be quite disjointed. Certainly those working on EBP projects have excellent intentions, but in today’s large and disparate hospitals and health systems, it’s difficult to coordinate teams and resources to produce the desired results. When those results aren’t achieved, the team members can become demoralized, shrinking their enthusiasm for both the process and the institution’s inability to realize EBP-driven improvements.
Although hospitals and health systems monitor the results of evidence-based practice, such as those that resulted in the execution of new policies, or projects they can submit for Magnet status, they may not be reviewing the EBP process itself. If project duplication has become the norm, or fewer projects are achieving the desired results, a fundamental evaluation of everything that goes into the process may be in order.
Make these changes to upgrade your EBP
It’s never too late for a hospital or health system to advance its evidence-based practice. In fact, an EBP evaluation should be a regular part of its organizational review. What else can you do right now to set your EBP apart from other institutions?
Commit to an evidence-based practice culture
Leadership from the top down is essential for EBP to make an impact. When you demonstrate knowledge about and understanding of the difference that EBP can make for your facility and your patients, that allegiance to EBP will be palpable and contagious.
Be open to new approaches and strategies
Are there resources that can help streamline your evidence-based practice process? Workflows, standards, and best practices that could improve the process itself, or the quality of project outcomes? Exploring the possibilities that could take your EBP projects to the next level is more necessary than ever before, thanks to the competition and staff shortages that healthcare facilities face.
Strengthen and support your EBP champions and teams
Whether team members are assigned or voluntary, fresh out of school or highly experienced, they should all work from a level playing field. Give them the tools that make it easier for them to communicate, coordinate, track, summarize, and disseminate their findings. And don’t forget to share their successes throughout the hospital or system! Showing that EBP does make a difference, the team and their colleagues will have a greater sense of accomplishment and pride in an organization dedicated to enhancing its clinical practice.
You have a lot on your plate: you’re trying to identify and attain operational efficiencies, advance patient safety, build staff engagement, and achieve high-quality clinical outcomes. When done right, evidence-based practice can contribute consistently to all these goals. It’s up to you to provide the EBP-focused leadership and support to make it happen.
