HEALTHCARE QUALITY AND
EVIDENCE BASED PRACTICE
DISHA PATEL
INTRODUCTION
• • Health care quality is a level of value
provided by any health care resource, as
determined by some measurement.
• • It is an assessment of whether something is
good enough and suitable for its purpose.
• • Goal: Provide high-quality medical resources
to all, ensure quality of life, cure illnesses.
Definition of Health Care Quality
• • "The degree to which health care services
for individuals and populations increase the
likelihood of desired health outcomes and are
consistent with current professional
knowledge."
• • - Institute of Medicine
Domains of Health Care Quality
• • Safe: Avoiding harm to patients.
• • Effective: Services based on scientific
knowledge.
• • Patient-centered: Respectful and responsive
care.
• • Timely: Reducing delays.
• • Efficient: Avoiding waste.
• • Equitable: Consistent quality across all
groups.
Types of Health Care Quality
Measures
• • Measures classified as:
• • - Structure
• • - Process
• • - Outcome
Structural Measures
• • Show provider's capacity, systems, and
processes.
• • Examples: Use of electronic records,
certified physicians, provider-to-patient ratio.
Process Measures
• • Reflect provider's actions for health
maintenance/improvement.
• • Examples: Percentage receiving
immunizations, diabetes blood sugar tests.
Outcome Measures
• • Reflect the impact of care on patient health.
• • Examples: Surgical mortality rates, hospital-
acquired infections.
• • Data sources are essential for measuring
quality.
EVIDENCE-BASED PRACTICE
(EBP)
INTRODUCTION
• • EBP is a problem-solving approach in health
care.
• • Combines best research, clinician expertise,
and patient values.
Definitions
• • Mulhall (1998): Clinical decisions using best
evidence, expertise, and preferences.
• • David Sackett (1996): Judicious use of
current best evidence.
• • CNA: Continuous process involving best
available evidence.
Components of EBP
• • Integrates clinical expertise with best
available research.
• • 1. Individual clinical expertise: Skills from
experience and practice.
Components of EBP (continued)
• • 2. Best available evidence: From medical
sciences and clinical research.
• • 3. Patient's values and preferences: Cultural
values and choices matter.
Need for Evidence Based Practice
• • Ensures best services for clients.
• • Supports lifelong learning.
• • Improves clinical judgement, patient care,
and saves lives.
Goals/Aims of Evidence Based
Practice
• • Deliver effective, cost-effective care.
• • Resolve clinical and community problems.
• • Enhance patient satisfaction and outcomes.
• • Support science of nursing and evidence-
based practices.
Steps of Evidence-Based Practice
(Part 1)
• • 1. Formulate well-built
patient/population/problem question.
• • 2. Question current practices.
• • 3. Integrate EBP as a standard.
• • 4. Collect best evidence.
• • Seven levels of evidence, I is strongest, VII
weakest.
Steps of Evidence-Based Practice
(Part 2)
• • Critically appraise evidence for:
• • 1. Results? 2. Validity? 3. Applicability?
• • Create evidence synthesis comparing
multiple studies.
Steps of Evidence-Based Practice
(Part 3)
• • Integrate evidence with expertise,
assessment, patient values.
• • Evaluate change and determine
improvement areas.
Benefits of EBP in Health Care (Part
1)
• • Improves quality of care.
• • Focus on patient-centered, improved
outcomes.
• • Reduces medical and nursing errors.
Benefits of EBP in Health Care (Part
2)
• • Prevents disease, promotes health.
• • Cost-effective, reduces care variability.
• • Encourages participation, innovation,
learning, collaboration, and safety.
Role of Nurses in EBP (Part 1)
• • Nurses as leaders, scientists, knowledge
transformers.
• • Resource managers, supporters of EBP.
Role of Nurses in EBP (Part 2)
• • Encourage collaboration and research.
• • Motivate, support intellectual curiosity.
• • Collaborate to deliver quality care.
ANY QUESTION?
THANK YOU!!!
