Using reliable and valid data and interventions supported by evidence contribute to the success of a change initiative. Stevens (2013) provides a framework for obtaining the data and applying the evidence to practice. The data collection and intervention process involves:
|1||Discovery||Bibliographic Databases such as CINAHL- provide single research reports, in most cases, multiple reports.|
|2||Evidence summary||Cochrane Collaboration Database of Systematic Reviews: Provides reports of rigorous systematic reviews on clinical topics. See www.cochrane.org/|
|3||Translation into guidelines||National Guidelines Clearinghouse: Sponsored by AHRQ, provides online access to evidence-based clinical practice guidelines. See www.guideline.gov|
|4||Integration into practice||AHRQ Healthcare Innovations Exchange: Sponsored by AHRQ, provides profiles of innovations and tools for improving care processes, including adoption guidelines and information to contact the innovator. See http://innovations.ahrq.gov/|
|5||Evaluation of process and outcome||National Quality Measures Clearinghouse: Sponsored by AHRQ, provides detailed information on quality measures and measure sets. See http://qualitymeasures.ahrq.gov/|
An example of the Agency for Healthcare Research and Quality (AHRQ) guidelines is those related to fall prevention. In this program, the AHRQ provides a comprehensive, ready-to-use training program about fall prevention in hospitals and a toolkit designed to support the necessary organizational changes to prevent falls. The program components are:
The Joint Commission (TJC), like the Leapfrog Group, and AHRQ is committed to improving the quality and safety of healthcare. It is “an independent, not-for-profit organization that accredits and certifies over 22,000 healthcare organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards” (TJC, 2019). TJC not only sets yearly patient safety goals but also provides guidance about how to meet those goals.
EXAMPLEIdentifying patients correctly is a 2020 National Patient Safety Goal (NPSG). TJC specifies that at least two patient identifiers (such as name and date of birth) be used to correctly identify a patient before a procedure, medication administration, etc. Hospitals monitor and track compliance with this NPSG. If the goal of 100% is not met, this triggers a need for a process change.
You are a member of a team chartered to implement a hospital-wide fall prevention program.
Authored by Anne E. Lara, Ed. D., MS, RN, CPHQ, CPHRM