A High Reliability Organization’s Use of the Evidence‐Based Practice Process to Eliminate an Identified Potential for Wrong‐Site Surgery

AORN Journal ◽  
2020 ◽  
Vol 112 (5) ◽  
pp. 520-523
Author(s):  
Salvacion Sonia Cruz ◽  
JoAnn Mick
Keyword(s):  
Evidence Based Practice ◽  
High Reliability ◽  
Evidence Based ◽  
Wrong Site Surgery ◽  
Wrong Site

scholarly journals The use of collaboration to implement evidence-based safe practices

2013 ◽  
Vol 2 (3) ◽  
pp. 26 ◽  
Author(s):  
John R. Clarke
Keyword(s):  
Patient Safety ◽  
Best Practices ◽  
Operating Room ◽  
Medical Error ◽  
Near Miss ◽  
Evidence Based ◽  
Wrong Site Surgery ◽  
Eastern Pennsylvania ◽  
One Year ◽  
Wrong Site

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year.

scholarly journals Interprofessional Evidence-Based Practice Education: Impact on Organizational Culture in Healthcare Settings

10.33496/003 ◽  
2019 ◽  
pp. 12-23
Keyword(s):  
Health Care ◽  
Interprofessional Education ◽  
Evidence Based Practice ◽  
High Reliability ◽  
Clinical Care ◽  
Evidence Based ◽  
Culture Of Safety ◽  
Healthcare Settings ◽  
Safety Research

A key strategy for improving the quality of health care is through the widespread implementation of evidence-based practice (EBP). Most importantly, EBP helps organizations achieve high reliability and a culture of safety. Research shows that EBP reduces morbidity, mortality, medical errors, and geographic variation in health care. This paper describes an interprofessional education intervention to transform clinical care and institutionalize EBP in one medical facility. Through the adoption of an intensive EBP training platform and the rapid implementation of EBP solutions to address traditional challenges, the organization is effectively accelerating its efforts to move from a health care system to a highly reliable system of health.

scholarly journals Validation and Psychometric Properties of the German Version of the Evidence Based Practice Attitudes Scale (EBPAS-36D)

2020 ◽  
Author(s):  
Katharina Szota ◽  
Jonathan Thielemann ◽  
Hanna Christiansen ◽  
Marte Rye ◽  
Gregory A. Aarons ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Factor Structure ◽  
Evidence Based Practice ◽  
Service Providers ◽  
Item Difficulty ◽  
High Reliability ◽  
Model Fit ◽  
Evidence Based ◽  
German Version ◽  
Good For

Abstract Background: The implementation of evidence-based practice (EBP) in mental health care confers many benefits to patients, and research into factors facilitating the implementation of EBP is needed. As an important factor affecting the implementation of EBP, service providers’ attitudes towards EBP emerged. The Evidence-Based Practice Attitude Scale (EBPAS-36) is an instrument with good psychometric characteristics that measures positive and ambivalent attitudes towards EBP. However, a German version is missing. The present study therefore aims to provide a validated German translation of the EBPAS-36.Methods: The scale was translated and back-translated as recommended by standard procedures. To evaluate the psychometric properties of the translated version, German psychotherapists (N = 599) were recruited to participate in an online survey. They provided demographic and professional information, completed the EBPAS-36, the Implementation Climate Scale (ICS) and the Intention Scale for Providers (ISP). Standard item and reliability analyses and exploratory (EFA) and confirmatory factor analyses (CFA) in two subsamples (random split) were conducted and correlations with demographic and professional characteristics calculated.Results: The item analyses showed a mean item difficulty of pi = .64, a mean inter-item correlation of r = .18, and a mean item-total correlation of ritc = .40. The internal consistency was very good for the total score (α = .89) and ranged from adequate to very good for the subscales (.65 – .89), indicating high reliability. The original factor structure showed an acceptable model fit (RMSEA = .064 (90% CI = .059–.068); SRMR = .0922; AIC = 1400.77), confirming the 12-factor structure of the EBPAS-36. However, a second-order factor structure derived by the EFA had an even better model fit (RMSEA = .057 (90% CI = .052–.062); SRMR = .0822; AIC = 1274.56). When the EBPAS-36 was entered in a hierarchical regression model with the criterion Intention to use EBP, the EBPAS-36 contributed significantly to the prediction (Change in R2 = .28, p < .001) over and above gender, age and working in science.Conclusions: The present study confirms good psychometric properties and validity of a German version of the EBPAS-36 in a sample of psychotherapists.

scholarly journals Making the Operating Theatre a 'High-Reliability' Environment

2012 ◽  
Vol 94 (5) ◽  
pp. 159-161
Author(s):  
Bryn Baxendale ◽  
Bryony Lovett
Keyword(s):  
Patient Outcome ◽  
High Reliability ◽  
Surgical Care ◽  
Operating Theatre ◽  
Public Healthcare ◽  
High Quality ◽  
The Public ◽  
Wrong Site Surgery ◽  
Never Events ◽  
Wrong Site

The public, healthcare commissioners and regulators rightly seek assurances about delivery of reliable, high-quality surgical care. The Department of health's 'never events' framework 1 specifically lists patient misidentification, wrong-site surgery and retained swabs and instruments as unacceptable occurrences. Professional conversations reveal many seemingly inconsequential daily occurrences that have an impact on patient outcome and ongoing management. Unfortunately, many of these incidents are not reported formally by those involved, which limits the opportunity for professionals and organisations to learn from subsequent analysis.

scholarly journals Evidence-Based Practice in Nursing

2015 ◽  
Author(s):  
Sandra Linde
Keyword(s):  
Registered Nurses ◽  
Evidence Based Practice ◽  
High Reliability ◽  
Medical Center ◽  
The United States ◽  
Survey Study ◽  
Evidence Based ◽  
Institute Of Medicine ◽  
Study Results ◽  
Evidenced Based

<p>Evidenced-based practice (EBP) as defined by the Institute of Medicine(IOM) is the integration of "best research with clinical expertise and patient values for optimum care"(IOM, 2003, p.45-46). Evidence-based practice (EBP) is considered a standard for safe and quality care (Carlson & Plonczynski, 2008). Healthcare leaders recognize EBP as an integral part of achieving quality outcomes and attaining high reliability. The Institute of Medicine (IOM) has established a goal that 90% of healthcare decisions in the United States be evidenced based by the year 2020 (IOM, 2009). Despite the fact that EBP has been promoted for many years, inconsistencies in implementation and adoption have been noted. Barriers to the implementation of EBP need to be understood. Assessing organizational culture has been identified as a necessary first step in to overcoming common barriers (Carlson & Plonczynski, 2008; Frasure, 2008). The purpose of this study was to assess the practice, attitudes and knowledge of EBP in registered nurses using the Evidence-Based Practice Questionnaire (EBPQ). The study used a descriptive design with convenience sampling. All staff registered nurses (RNs), Clinical Managers (CMs) and Assistant Clinical Managers (ACMs) on inpatient units within a large medical center in the Northeast were invited to participate in this survey. Study results are similar to those found in literature previously cited: a positive attitude towards EBP with a lower perception of knowledge or practice (Melnyk et al., 2004) and belief that more knowledge is needed (Alspach, 2006; Melnyk et al., 2004; Melnyk, Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). This assessment indicates a degree of environmental readiness and provides relative estimation of educational needs.</p>

scholarly journals Development and evaluation of a spiral model of assessing EBM competency using OSCEs in undergraduate medical education

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
B. Kumaravel ◽  
C. Stewart ◽  
D. Ilic
Keyword(s):  
Medical Students ◽  
Assessment Tool ◽  
Evidence Based Practice ◽  
High Reliability ◽  
Core Competencies ◽  
Test Theory ◽  
Assessment Tools ◽  
Evidence Based ◽  
High Stakes ◽  
Spiral Model

Abstract Background Medical students often struggle to understand the relevance of Evidence Based Medicine (EBM) to their clinical practice, yet it is a competence that all students must develop prior to graduation. Objective structured clinical examinations (OSCEs) are a valued assessment tool to assess critical components of EBM competency, particularly different levels of mastery as they progress through the course. This study developed and evaluated EBM based OSCE stations with an aim to establish a spiral approach for EBM OSCE stations for undergraduate medical students. Methods OSCE stations were developed with increasingly complex EBM tasks. OSCE stations were classified according to the classification rubric for EBP assessment tools (CREATE) framework and mapped against the recently published core competencies for evidence-based practice (EBP). Performance data evaluation was undertaken using Classical Test Theory analysing mean scores, pass rates, and station item total correlation (ITC) using SPSS. Results Six EBM based OSCE stations assessing various stages of EBM were created for use in high stakes summative OSCEs for different year groups across the undergraduate medical degree. All OSCE stations, except for one, had excellent correlation coefficients and hence a high reliability, ranging from 0.21–0.49. The domain mean score ranged from 13.33 to 16.83 out of 20. High reliability was demonstrated for the each of the summative OSCE circuits (Cronbach’s alpha = 0.67–0.85). In the CREATE framework these stations assessed knowledge, skills, and behaviour of medical students in asking, searching, appraising, and integrating evidence in practice. The OSCE stations were useful in assessing six core evidence-based practice competencies, which are meant to be practiced with exercises. A spiral model of OSCEs of increasing complexity was proposed to assess EBM competency as students progressed through the MBChB course. Conclusions The use of the OSCEs is a feasible method of authentically assessing leaner EBM performance and behaviour in a high stakes assessment setting. Use of valid and reliable EBM-based OSCE stations provide evidence for continued development of a hierarchy of assessing scaffolded learning and mastery of EBM competency. Further work is needed to assess their predictive validity.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Current Issues: Evidence-Based Practice for the Real World: Thoughts on Clinical Education in Communication Disorders

2010 ◽  
Vol 20 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Anne K. Bothe
Keyword(s):  
Clinical Education ◽  
Real World ◽  
Evidence Based Practice ◽  
Communication Disorders ◽  
University Faculty ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Basic Principles ◽  
The Real ◽  
Language Pathology

This article presents some streamlined and intentionally oversimplified ideas about educating future communication disorders professionals to use some of the most basic principles of evidence-based practice. Working from a popular five-step approach, modifications are suggested that may make the ideas more accessible, and therefore more useful, for university faculty, other supervisors, and future professionals in speech-language pathology, audiology, and related fields.

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