Impact Measurement: Quantifying EBP Effectiveness

Evidence-based practice (EBP) methods have gained recognition as key components to provision of excellent interdisciplinary healthcare.  Magnet recognition, the Doctor of Nursing Practice (DNP) degree, and endorsement of EBPs by payers, professional organizations and government agencies have fueled widespread acceptance of EBP methods.  But lacking in these methods has been clear direction on quantifying the "impact" of EBP on patient, nursing services and hospital outcomes.  In fact, most EBP studies are conducted using relatively simple quality improvement techniques that lack the ability to attribute a causal relationship between the practices adopted and the results achieved.   Additionally, the ability to implement practice changes that are long-lasting, resilient and genuinely accepted by practitioners remains a daunting task, especially when evidence that demonstrates a shift toward improved results is lacking to garner support.  Yet, since Codman’s call for measurement of “end-results” in 1917, to Donabedian’s and Ellwood’s frameworks for quality management in the 1980s, quantification of “performance impact” associated with the methods used to provide healthcare has been advocated.  If healthcare agencies are to continue to value the significant workload and staff costs associated with adoption of an EBP culture, inclusion of methods that measure the impact of this work must be embraced.   This opening symposium session presents a framework for EBP “impact measurement.”  Impact study designs will be described, compared and contrasted using actual case examples from a variety of clinical practice settings, and benefits associated with the conduct of phase IV effectiveness studies will be discussed.