Channels 4 Change: An evidence-based process for projects and decision-making

Monday, 18 November 2013: 10:20 AM

Karen J. Vander Laan, PhD, MSN, RN
Nursing Practice & Development, Spectrum Health, Grand Rapids, MI

Learning Objective 1: Understand the Channels 4 Change process and supporting documents.

Learning Objective 2: Translate use of an evidence-based process to projects and decision-making.

As nurse leaders, how can we assure that changes we make are reflective of evidence-based practice (EBP)?  In 2009 our Nursing Research Council identified the need to map out a “channel for change” as a way to advance EBP in our organization.  A team was formed and sponsored to achieve three objectives:  1) help nurses recognize EBP already occurring in our organization, 2) connect nurses to existing organizational EBP resources, and 3) define a consistent evidence-based process for proposing and deciding practice and operational changes.  After five months of intensive study, the team introduced Channels 4 Change (C4C), a synthesized evidence-based process for use in inquiry projects and decision-making.  A toolkit was developed, piloted from 2010-2011 by nurses who frequently lead or support projects/task forces, and refined in 2011 to its current resources (workbook, playbook, proposal form, project summary, presentation template).  Based on the Iowa Model of EBP, projects and decision-making systematically proceed through four steps.  First the problem or opportunity is defined and proposed.  If endorsed as a priority, then a team is formed to obtain input from stakeholders to shape the project or decision.  Next, available evidence is obtained and appraised to determine how best to proceed.  If the team’s plan is endorsed by the sponsor, an inquiry project (e.g., research, quality or operational improvement, innovation) is developed and launched or a decision is announced, often as a pilot.  Based on defined process and outcome indicator results, the team and sponsor can decide whether or not to adopt the change.  A project summary captures all project/decision details and lessons learned; toolkit documentation along the way prepares the team to disseminate its results.  We continue to experiment—small consecutive workshops, large team simultaneous use—to add to our growing C4C evidence base.  C4C has equipped us for EBP!