Week 7: Discussion Question - Enhancing The Sustainability O ✓ Solved

Week 7: Discussion Question -Enhancing the Sustainability of EBP I

Discuss an EBP initiative that was implemented in a health care setting (use fictitious names for people and places) and whether it was successful or not sustainable, with rationale. Choose one of four models of organizational change that you would use in an advanced nursing role to enhance sustainability of EBP initiatives.

Paper For Above Instructions

Enhancing the sustainability of evidence-based practice (EBP) initiatives in healthcare is crucial for improving patient outcomes and optimizing resources. This paper discusses a fictional EBP initiative implemented at Sunnyvale Health Center, focusing on a new protocol to reduce hospital readmission rates for patients with congestive heart failure (CHF).

At Sunnyvale Health Center, the CHF readmission reduction initiative was aimed at implementing a comprehensive discharge planning process, inclusion of patient education, and follow-up care coordination. The initiative involved training nurses to effectively communicate discharge instructions and provide patients with information about managing their condition at home. Despite thorough planning and execution, this initiative faced sustainability challenges due to several factors, including staff turnover, inadequate follow-up resources, and a lack of sustained engagement from patients.

The success of the EBP initiative can be measured through various metrics, such as readmission rates and patient satisfaction. Initially, improvements in readmission rates were observed; however, over time, the rates began to rise again, indicating a loss of adherence to the protocol. Feedback from staff highlighted that high staff turnover resulted in inconsistencies in adherence to the new protocols. Moreover, patients reported confusion regarding their discharge instructions, further emphasizing the need for improvements in patient education and follow-ups.

To enhance the sustainability of the EBP initiative, I propose utilizing the Kotter's 8-Step Change Model, which emphasizes the importance of a structured approach to manage change effectively (Kotter, 2012). This model outlines the following steps:

  1. Create urgency: It’s essential to foster a sense of urgency among the staff to recognize the importance of reducing CHF readmissions.
  2. Build a guiding coalition: Engaging a team of dedicated individuals, including nurse leaders, physicians, and social workers, is crucial for driving the initiative.
  3. Develop a vision and strategy: A clear vision that outlines goals and strategies for the initiative must be effectively communicated to all staff members.
  4. Communicate the vision: Ensuring that all members of the healthcare team are informed about the vision and the importance of their roles in achieving success.
  5. Empower broad-based action: Encourage nurses and staff members to adopt the new protocols by providing them with the necessary resources and support.
  6. Generate short-term wins: Celebrate initial successes, such as reduced readmission rates over a specific timeframe, to motivate staff.
  7. Consolidate gains and produce more change: Analyze the effectiveness of initial changes and refine strategies to further improve the initiative.
  8. Anchor new approaches in the culture: Ensure that the successful elements of the initiative become embedded in the organization’s culture by continually promoting adherence to the protocols.

Implementing Kotter's model can facilitate a structured approach to reinforcing the importance of the CHF discharge planning initiative and addressing the barriers faced. For instance, establishing a dedicated team to lead the initiative can provide stability amidst staff turnover and ensure consistent training and reinforcement of protocols to new hires. Additionally, integrating ongoing patient education into the discharge process will enhance patient understanding and adherence to their care plans, which is vital for long-term success.

Furthermore, it’s important to address the need for effective follow-up care coordination. Incorporating a case management system that proactively checks in with patients post-discharge can help identify issues before they lead to readmission. This can be achieved by scheduling follow-up appointments during the discharge process and reminding patients of these appointments through calls or text messages. These practices will ensure that patients remain engaged and informed about their health management.

In conclusion, while the CHF readmission reduction initiative at Sunnyvale Health Center showed promise in its early stages, its long-term sustainability was jeopardized by several factors, including staff turnover and patient engagement challenges. By adopting Kotter's 8-Step Change Model, the healthcare organization can address these challenges systematically and enhance the sustainability of EBP initiatives moving forward. Ensuring ongoing training, effective communication, and strong follow-up care will be essential components in fostering a culture of evidence-based practice, ultimately leading to improved patient outcomes and reducing unnecessary readmissions.

References

  • Kotter, J. P. (2012). Leading Change. Harvard Business Review Press.
  • Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice. Wolters Kluwer.
  • Bourgault, A. M., & Melnyk, B. M. (2018). Evidence-Based Practice Implementation: An Overview. Nursing Administration Quarterly, 42(1), 66-73.
  • McCabe, C. (2020). Sustaining Evidence-Based Practices in Healthcare: A Literature Review. Journal of Nursing Scholarship, 52(6), 1220-1229.
  • Civljak, M., & Sheikh, A. (2019). Implementing Evidence-Based Practice to Improve Healthcare Outcomes. Healthcare, 7(1), 48.
  • Melnyk, B. M., & Smith, D. (2020). A Practical Guide for Implementing Evidence-Based Practice. American Nurse Journal, 15(6), 34-38.
  • Ben Natan, M., & Mahajna, M. (2018). Organizational Change in Health Care: The Role of Culture and Leadership. Leadership in Health Services, 31(2), 178-190.
  • Sharma, R., & Malla, M. (2019). Factors Affecting the Sustainability of Evidence-Based Practices in Nursing. Journal of Evidence-Based Medicine, 12(2), 456-461.
  • Carney, M. L., & Segal, S. (2021). Patient Engagement Strategies in Discharge Planning: A Review. Journal of Hospital Medicine, 16(3), 187-194.
  • Huang, J. Y., & Wang, C. C. (2021). Enhancing Patient Education in Healthcare: Challenges and Strategies. International Journal of Nursing Studies, 115, 103858.

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